synonyms: pisiform fx
Pisiform Fracture ICD-10
A- initial encounter for closed fracture
B- initial encounter for open fracture
D- subsequent encounter for fracture with routine healing
G- subsequent encounter for fracture with delayed healing
K- subsequent encounter for fracture with nonunion
P- subsequent encounter for fracture with malunion
Pisiform Fracture ICD-9
- 814.04 (closed pisiform fx)
Pisiform Fracture Etiology / Epidemiology / Natural History
- usually secondary to a direct blow to the hypothenar eminence.
Pisiform Fracture Anatomy
- The pisiform is the insertion site of the flexor carpi ulnaris.
Pisiform Fracture Clinical Evaluation
Pisiform Fracture Xray / Diagnositc Tests
- carpal tunnel view
- 30 degree supination view
Pisiform Fracture Classification / Treatment
- May be small avulsion chip fractures, longitudinal split or comminuted fractures.
- RX=short arm cast for 4-6 weeks.
- Consider excision for severely displaced fractures, or in non-operative treatment leads to nonuion or painful malunion.
- 3-4cm palmar zigzag incision centered on pisiform
- retract ulnar nerve and artery radially
- split FCU longitudinally
- excise pisiform
- repair tendon
Pisiform Fracture Associated Injuries / Differential Diagnosis
Pisiform Fracture Complications
Pisiform Fracture Follow-up Care
Pisiform Fracture Review References
- Vasilas A, Grieco RV, Bartone NF. Roentgen aspects of injuries to the pisiform bone and pisotriquetral joint. JBJS 1960;42A:1317