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. 2021 Mar 31;57(2):341-344.
doi: 10.1055/s-0040-1722589. eCollection 2022 Apr.

Isolated distal pisiform dislocation: Case Report

Rafael Dias  1 , Teresa Alves-da-Silva  1 , Carlos Martinho  1 , Francisco Guerra-Pinto  1
Affiliations

Isolated distal pisiform dislocation: Case Report

Rafael Dias et al. Rev Bras Ortop (Sao Paulo). .

Abstract

Isolated pisiform dislocation is a rare lesion with few cases described in the literature. This type of lesion is typically observed in young males and can be easily overlooked at first assessment. Isolated proximal dislocation is more common due to the action of the flexor carpi ulnaris (FCU) muscle. We present the case of a 19-year-old male patient with isolated distal pisiform dislocation after wrist trauma. He underwent open reduction and internal fixation with Kirschner wires with excellent functional outcomes. Although there is no consensual therapeutic method, closed reduction is a first-line treatment for acute presentations. Pisiform open reduction or excision may be performed alternatively or after a failed closed reduction.

Keywords: carpal bones; joint dislocations; pisiform; wrist injuries.

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Conflict of interest statement

Conflito de Interesses Os autores declaram não haver conflito de interesses. O estudo foi realizado em conformidade com a Declaração da Associação Médica Mundial de Helsinque sobre Princípios Éticos para Pesquisa Médica Envolvendo Seres Humanos.

Figures

Fig. 1
Fig. 1
Initial radiograph demonstrating a distal pisiform dislocation.
Fig. 2
Fig. 2
Computed tomography scan (with three-dimensional reconstruction) showing pisiform dislocation and no other concomitant lesions.
Fig. 3
Fig. 3
Immediate postoperative radiograph demonstrating the anatomical reduction of the pisiform and its fixation to the triquetral bone with Kirschner wires.
Fig. 4
Fig. 4
(A) Radiograph of the left wrist at 12 weeks postoperatively, revealing the sustained pisiform reduction; (B) Radiograph of the right wrist.
Fig. 5
Fig. 5
Photograph of the patient demonstrating a symmetrical range of motion.
Fig. 1
Fig. 1
Radiografia inicial a demonstrar a luxação distal do pisiforme.
Fig. 2
Fig. 2
Tomografia computorizada (reconstrução tridimensional) a demostrar a luxação do pisiforme sem outras lesões associadas.
Fig. 3
Fig. 3
Radiografia no período pós-operatório imediato a demonstrar a redução anatómica do pisiforme, fixado ao piramidal com fios de Kirschner.
Fig. 4
Fig. 4
(A) Radiografia do punho esquerdo às 12 semanas pós-operatório: redução do pisiforme mantida; (B) Radiografia do punho direito.
Fig. 5
Fig. 5
Fotografia do paciente a demonstrar um arco de movimento simétrico.
See this image and copyright information in PMC

References

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