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Pisiform fracture
From WikEM
Contents
Background
- Occurs via fall onto hypothenar eminence
- Forced wrist flexion or strain from lifting heavy objects can avulse the pisiform[1]
- Must exclude injury to ulnar nerve/artery (pisiform forms bony wall of Guyon's canal)
Clinical Features
- Localized tenderness on the pisiform itself, especially if with resisted wrist flexion[1]
Differential Diagnosis
Carpal fractures
- Scaphoid fracture
- Triquetrum fracture
- Lunate fracture
- Trapezium fracture
- Pisiform fracture
- Hamate fracture
- Capitate fracture
- Trapezoid fracture
Evaluation
- Obtain x-rays in partial supination or carpal tunnel view (removes overlap with triquetrum)
Management
- Compression dressing or forearm volar splint in 30 degrees of flexion with ulnar deviation
Disposition
- Outpatient
