Citation, DOI, disclosures and article data
At the time the article was created Aaron Wong had no recorded disclosures.View Aaron Wong's current disclosures
At the time the article was last revised Henry Knipe had no recorded disclosures.View Henry Knipe's current disclosures
The pisiform sits in an anterior plane to the rest of the carpal bones and articulates with the triquetrum. It has a spherical shape with a slight distolateral long axis. The articular dorsal surface is flat, forming the pisotriquetral joint, whilst the palmar surface is rough and round and provides for muscular attachment. It is the only moving structure of the carpal canal 5.
The ulnar artery sits adjacent to a lateral surface groove of the pisiform.
The ulnar artery provides vascularity with branches entering both proximal and distal surfaces. Proximal vessels enter inferior to the triquetral facet near the tendon of the flexor carpi ulnaris. Superior and inferior branches run beneath the articular surface and along the palmar cortex respectively. Distal entering vessels run parallel to the palmar cortex and anastomose with the proximal vessels. Superior proximal and distal vessels form an arterial ring deep to the facet.
- os pisiforme secundarium: can be mistaken for a fracture, located at proximal pisiform pole
Distal avulsion and vertical fracture may occur from a direct blow, especially when the pisiform is tensed from the flexor carpi ulnaris. Mechanism often includes a fall onto an outstretched hand.
The pisotriquetral joint is a common site of wrist osteoarthritis.
Often the last carpal bone to ossify, the pisiform has one ossification center that ossifies in the ninth to twelfth year, later in males.
History and etymology
Derived from the Latin word pisum, pisiform means ‘pea-shaped’.
- 1. James R. Doyle. Surgical Anatomy of the Hand and Upper Extremity. (2003) ISBN: 9780397517251
- 2. Standring S, Borley N, Collins P et al. Gray's Anatomy Fortieth Edition. Churchill Livingstone. 2008.
- 3. Theumann N, Pfirrmann C, Chung C, Antonio G, Trudell D, Resnick D. Pisotriquetral Joint: Assessment with MR Imaging and MR Arthrography. Radiology. 2002;222(3):763-70. doi:10.1148/radiol.2223010466
- 4. Butler, Paul, 1952 June 4-, Mitchell, Adam W. M., Ellis, Harold, 1926-. Applied Radiological Anatomy. (1999) ISBN: 0521481104
- 5. Laude M, Le Gars D, Boudin G. [Functional Anatomy of the Pisiform Bone]. Bull Assoc Anat (Nancy). 1979;63(183):451-8. PMID 553675