PMC6968647_01
(a) X-ray (anteroposterior view) of the right hand, showing the displaced pisiform fracture. (b) X-ray (lateral view) of the right hand, showing the displaced pisiform fracture.
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He also had a left closed undisplaced scaphoid fracture and a right pisiform fracture (Figure 1(a,b)).
(a) X-ray (anteroposterior view) of the right hand after an unsuccessful manual closed reduction. (b) X-ray (lateral view) of the right hand after an unsuccessful manual closed reduction.
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Post-reduction radiographs did not show satisfactory alignment (Figure 2(a,b)).
Decompression of the ulnar nerve. The proximally displaced fragment of the pisiform is indicated by the scalpel.
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Intraoperatively, the ulnar nerve was found to be in continuity and contused over the fracture site at zone 1, proximal to the bifurcation of the ulnar nerve (Figure 3).
(a) X-ray (anteroposterior view) of the right hand before complete excision and removal of the comminuted pisiform. (b) X-ray (lateral view) of the right hand after complete excision and removal of the comminuted pisiform.
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The distal and proximal fragments of the pisiform were removed, and the Guyon canal was decompressed (Figure 4(a,b)).