The pisiform is a sesamoid bone in the FCU tendon, articulating with the triquetrum at the pisotriquetral joint on its dorsal surface. It acts as a lever for the FCU tendon, increasing its mechanical advantage. Pisiform fractures from direct impact or stress fractures produce ulnar palmar wrist pain reproduced by pisiform compression and lateral glide. Pisiform excision is the definitive treatment for pisotriquetral arthritis.
An expanded entry for Pisiform.
| Articulations | |
|---|---|
| Landmarks | |
| Ossification | Ossification centre appears at 9-12 years, the last carpal bone to ossify. |
Pisotriquetral arthritis produces ulnar palmar wrist pain reproduced by the pisotriquetral grind test (compression with lateral glide). Injection into the pisotriquetral joint provides diagnostic and therapeutic benefit. Pisiform excision preserves the pisohamate and pisometacarpal ligaments and maintains FCU force transmission.
A direct blow to the hypothenar eminence fractures the pisiform and can irritate the ulnar nerve in Guyon's canal.
Degeneration of the pisotriquetral joint causes ulnar palmar wrist pain with gripping.
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