Dislocation fracture of the pisiform in a 14-year-old—a rare injury to the hand

• Published in: European journal of plastic surgery 2016-06, Vol.39 (3), p.225-228
• Main Authors: Maduz, Roman, Graf, Christina, Jandali, Abdul Rahman, Sproedt, Julia
• Format: Article
• Language: English
• Subjects: Case Report; Medicine; Medicine & Public Health; Plastic Surgery
• ISSN: 0930-343X; 1435-0130
• DOI: 10.1007/s00238-015-1133-y

Isolated dislocation or dislocation fracture of the pisiform are rare injuries with only few cases reported in the literature. Injuries to the pisiform occur more often in combination with other carpal injuries as the sturdiness and stability of its ligamentous attachments protect it from dislocating following a minor trauma. The most cases of dislocation or fracture occur following a direct trauma to the palmar and ulnar aspects of the wrist. Predominantly young male patients present with this problem. We present a case of a 14-year-old female who suffered from a dislocation fracture after falling from her bicycle on her outstretched hand. After confirming the diagnosis of pisiform dislocation fracture and reviewing the literature, we performed pisectomy with rerouting of the flexor carpi ulnaris tendon by suturing it to the ligamentous attachments. These rare injuries to the wrist are demanding in diagnostics and treatment and could be neglected in acute period. However, with a correct diagnosis and appropriate treatment, an excellent clinical outcome can be achieved. Level of Evidence: Level V, diagnostic study