Does pisiform subluxation affect the postoperative outcomes in a cohort of patients with distal radius fractures?

Abstract

BackgroundIn this study, we retrospectively surveyed the presence or absence of pisiform subluxation in surgically treated distal radius fractures (DRF) cases. In addition, we investigated whether or not the postoperative short-term treatment outcome differs due to the presence of pisiform subluxation.Materials and methodsThe subjects were 134 DRF patients treated with volar locking plate fixation (53 males and 81 females, mean age: 64 years old). The pisotriquetral joint was observed on a preoperative CT to investigate the presence or absence of pisiform subluxation according to the criteria reported by Vasilas. 134 patients divided into subluxation group and non-subluxation group, and the clinical outcomes were compared between these groups.ResultsPisiform subluxation was noted in 23.1% (31 patients, 15 males and 16 females, mean age 61 years). No significant difference was noted in patient background in both groups. The postoperative pronation angle in the non-subluxation group was significantly greater than that in the subluxation group, but there was no significant difference in any other parameter (the range of motion of the wrist, grip strengths, VAS, Q-DASH scores, and Mayo score) between these 2 groups. However it concomitantly occurred in 23.1% of DRF cases in our series, there was no significant difference in the postoperative treatment outcome between these 2 groups.ConclusionsTherapeutic intervention of pisiform subluxation is unnecessary during treatment of DRF, since pisiform subluxation does not affect the postoperative clinical outcomes of distal radius fractures.

The effect of ulnar variance on the pisotriquetral joint

“…Vasilas et al defined the radiographic criteria of PTJ subluxation as widening of the joint space by >4 mm, angulation between the articular surfaces >20°, and displacement in the proximodistal plane >15% (25). However, bone superimpositions make this evaluation difficult and often erroneous (18,26). Magnetic resonance imaging (MRI) is preferred to demonstrate the ligamentous stabilizers of PTJ.…”

Joystick reduction and percutaneous Kirschner wire stabilisation for dislocation of the pisiform

“…1 At least in the short term, it is not clear that all cases of pisiform dislocation or subluxation require treatment. 2 There is a small subset of reported cases where treatment has been required for a dislocated or subluxed pisiform. 3e6 These reports usually describe protracted ulnar sided wrist pain and restricted range of movement.…”