Pisiform fracture: Difference between revisions
No edit summary |
No edit summary |
||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*Occurs via fall onto hypothenar eminence | *Occurs via fall onto hypothenar eminence | ||
*Forced wrist flexion or strain from lifting heavy objects can avulse the pisiform<ref name="Hand and wrist emergencies">German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref> | |||
*Must exclude injury to ulnar nerve/artery (pisiform forms bony wall of Guyon's canal) | *Must exclude injury to ulnar nerve/artery (pisiform forms bony wall of Guyon's canal) | ||
| Line 11: | Line 11: | ||
==Evaluation== | ==Evaluation== | ||
*Obtain x-rays in partial supination or carpal tunnel view (removes overlap with triquetrum) | |||
[[File:Pisiform_Fracture.jpg|thumb|Pisiform fracture]] | [[File:Pisiform_Fracture.jpg|thumb|Pisiform fracture]] | ||
==Management== | ==Management== | ||
| Line 18: | Line 19: | ||
==Disposition== | ==Disposition== | ||
* | *Discharge with referral to orthopedic surgery | ||
==See Also== | ==See Also== | ||
[[ | *[[Carpal fractures]] | ||
==References== | ==References== | ||
Revision as of 20:39, 4 July 2017
Background
- Occurs via fall onto hypothenar eminence
- Forced wrist flexion or strain from lifting heavy objects can avulse the pisiform[1]
- Must exclude injury to ulnar nerve/artery (pisiform forms bony wall of Guyon's canal)
Clinical Features
- Localized tenderness on the pisiform itself, especially if with resisted wrist flexion[1]
Differential Diagnosis
Carpal fractures
- Scaphoid fracture
- Lunate fracture
- Triquetrum fracture
- Pisiform fracture
- Trapezium fracture
- Trapezoid fracture
- Capitate fracture
- Hamate fracture
Evaluation
- Obtain x-rays in partial supination or carpal tunnel view (removes overlap with triquetrum)
Management
- Compression dressing or forearm volar splint in 30 degrees of flexion with ulnar deviation
Disposition
- Discharge with referral to orthopedic surgery