Pisiform FracturesThis is a featured page


Introduction
The pisiform is uncommonly fractured. When the radiographer is presented with a suspected pisiform fracture, a knowledge of the appropriate supplementary views will potentially assist in confirming the fracture.

Mechanism of Injury
The pisiform is typically injured by a fall on an outstretched hand in a dorsiflexed position, with the impact on the hypothenar eminence Bryan C Hoynak, Laura Hopson, MD, e medicine


Anatomy
The pisiform is a sesamoid bone within the tendon of the flexor carpi ulnaris. It articulates only with the triquetrum and lies near the deep ulnar nerve and artery.


Incidence
The average incidence of pisiform fractures is 0.2% of all carpal fractures and approximately half of them are isolated fractures.
M. Tayfun Altınok MD. , Kadir Ertem MD , Ahmet Sığırcı MD , Alpay Alkan MD An Isolated Acute Pisiform Fracture: Usefulness Of MR Imaging


Radiography

pisiform fractures


Michael A Fleege, Pisiform Fractures, Skeletal Radiology, 1991: 20 p161



Demonstration of pisiform fractures will usually require dedicated radiographic techniques. In particular, a 20 degree supinated lateral wrist and carpal tunnel view may be helpful. In a study by Fleege et al (1991), the PA view was also found beneficial in demonstrating pisiform fractures.


pisiform fractures

Michael A Fleege, Pisiform Fractures, Skeletal Radiology, 1991: 20 p161




pisiform fracturespisiform fracturespisiform fracturespisiform fracturespisiform fractures carpal tunnel view
The PA wrist view demonstrates a suspected pisiform fractureThe scaphoid view tends to superimpose the pisiform over the hamate to no particular advantageIn a correctly positioned lateral wrist, the pisiform will be superimposed over the scaphoidA lateral wrist with 20 degrees of supination will result in a useful demonstration of the pisiformA carpal tunnel view will also demonstrate the pisiform well, and in this case, demonstrates the suspected pisiform fracture


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M.J.Fuller
M.J.Fuller
Latest page update: made by M.J.Fuller , Jun 23 2009, 12:05 AM EDT (about this update About This Update M.J.Fuller Edited by M.J.Fuller

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