Pisiform fracture

Last revised by Rohit Sharma on 22 Mar 2024

Pisiform fractures are an uncommon fracture of the carpal bones.

They are only thought to account for ~1-2% of all carpal fractures. Some older sources suggest that they are rarer than this but consensus seems to be that trapezoid fractures are the rarest 6.

Approximately 50% occur in association with other carpal fractures

Very rarely the pisiform may be dislocated without fracture and displaced radially.

Some can be occult on plain film. The pisotriquetral joint is best seen in the lateral view with 30 degrees supination or using the carpal tunnel view.

They are usually managed by immobilization in either a plaster cast or a wrist splint. In certain circumstances, placement of a pin-screw or excision is performed.

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