Lower Ulnar Nerve Palsy Related to Fracture of the Pisiform Bone in Patients with Multiple Injuries

Carpal Bone Fractures

“…Because of the close proximity of the ulnar nerve to the pisiform, ulnar nerve dysfunction can occur in conjunction with a pisiform fracture. This dysfunction is most likely to be caused by a direct blow injury to the nerve itself, but a compressive neuropathy secondary to a displaced pisiform fracture probably should be explored, and the pisiform bone should be excised on a more acute basis [35].…”

Acute ulnar nerve compression associated with pisiform fracture – a case report and literature review

“…Out of a total of 31 relevant case studies on pisiform fractures, only 4 case reports indicated ulnar neuropathy following acute pisiform fracture and included management plans with outcomes following treatment [1,6,7,9]. The management and outcomes were varied as seen in Table 1.…”

“…At three weeks' follow up, there was complete neurological and functional recovery with mild effort induced pain in the hypothenar area. Matsunaga et al [9] explored the distal ulnar tunnel with excision of entire pisiform bone for two cases: one non-union of pisiform fracture and one comminuted fracture; at 19 and 21 months' follow-up respectively, there was slight numbness in the ring and little fingers for one of the cases, but no weakness of the intrinsic muscles in both cases. Agathangelidis et al [1] presented a case of open pisiform fracture that was managed by internal fixation with cerclage.…”

Fractures of Carpal Bones Other than the Scaphoid

“…The integrity of the ulnar nerve should be assessed, due to its proximity to the pisiform [ 14 ]. Standard wrist views are usually suffi cient to visualise these injuries.…”