Locked Traumatic Pisiform Dislocation

Abstract

Case: A 32-year-old man presented to the emergency department with several carpal bone fractures and a locked distal pisiform dislocation after trauma. Treatment consisted of open surgical and reduction, osteosynthesis with a single Kirschner wire, and ligament repair. The patient's functional outcome was excellent, and his Mayo wrist score was 90 at 36 months after injury. Conclusions: Pisiform dislocations may be difficult to diagnose because anteroposterior and lateral radiographs may not be sufficient to visualize the injury. A 30° semisupinated wrist x-ray and computed tomography can be helpful. A satisfactory clinical result may be achieved if distal pisiform dislocations are detected early and managed surgically with open reduction and ligament repair.

Pisiform Bone Dislocation in a Pediatric Patient: What is the Best Treatment? Case Report and Review of the Literature

“…and "fracture." Since the review by Hurni et al, 1 only one of seven published reports [8][9][10][11][12][13][14] described the PB fracture dislocation in pediatric population. 14 PB dislocations are generally due to two mechanisms.…”

“…A systematic research using PubMed and Google Scholar databases was performed. The keyword “pisiform” was used in combination with “luxation,” “dislocation,” “displacement,” and “fracture.” Since the review by Hurni et al, 1 only one of seven published reports 8 9 10 11 12 13 14 described the PB fracture dislocation in pediatric population. 14…”

An uncommon case of traumatic pisiform dislocation with triquetral fracture

“…The former mechanism tends to cause distal dislocation, while the latter indirect mechanism tends to cause proximal dislocation as FCU contraction results in avulsion and dislocation of the pisiform proximally [5]. Distal dislocation is more common in the published literature [6]. Ulnar deviation of the wrist would cause medial displacement of the pisiform.…”

“…The treatment options vary and include closed reduction and immobilization, open reduction with internal fixation, and resection of the pisiform [2,5,6]. In acute cases, immediate closed reduction of the pisiform with the wrist flexed, pronated and ulnar deviated to relax the FCU may be attempted.…”