Orthopaedic Sports Medicine Center of Ioannina

Four cases of pisiform fracture are presented. In one case the largest fragment of the pisiform bone with the articular surface was dislocated. After open reduction, osteosynthesis with K-wires was performed. Two patients had an isolated fracture without fragment dislocation. They had their lower arms immobilized with a plaster of Paris cast for 4 weeks. In the fourth case the fracture of the pisiform bone was associated with an intraarticular distal radial fracture and wrist dislocation. The typical traumatic cause of pisiform fracture is a fall onto the outstretched hand. Immobilization for 4 weeks results in functional recovery. In cases with dislocation of the pisotriquetral joint open reduction and osteosynthesis are necessary. Excision of the pisiform bone is not indicated in a fresh injury.