Isolated pisiform fracture

Case contributed by Ryan Walsh
Diagnosis certain

Presentation

Hyperextension injury to right wrist playing rugby. Bony tenderness to distal radius and ulna with reduced range of movement.

Patient Data

Age: 10 years
Gender: Male
x-ray
Lateral
Frontal
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Info

Fracture of pisiform.

ct
This study is a stack
Axial
non-contrast
This study is a stack
Coronal
non-contrast
This study is a stack
Sagittal
non-contrast
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Info

Comminuted fracture of the pisiform bone with associated soft tissue swelling at the attachment of the flexor carpi ulnaris and abductor digiti minimi tendons. Fragments show minor displacement.

Case Discussion

Fracture of the pisiform bone is a rare type of carpal bone fracture accounting for 2% of all carpal bone fractures 1-3. In most cases, approximately half are associated with fractures of other carpal bones 2. Delay in diagnosis can lead to disabling consequences for patients, therefore early identification and management are key.

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