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Pisiform Fracture S62.163A 814.04

 

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

S- sequela

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.

Pisiform Technique

  • 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