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CC BY-NC-ND 4.0 · Journal of Morphological Sciences 2019; 36(02): 134-137
DOI: 10.1055/s-0039-1683860
Case Report
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Clinical and Anatomical Aspects of Anterior Dislocation of the Pisiform Bone

Carlos Romualdo Rueff-Barroso
1   Department of Morphology, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
,
Fernanda Vieira Botelho Delpupo
1   Department of Morphology, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
,
Valéria Paula Sassoli Fazan
2   Department of Surgery and Anatomy, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
,
Sérgio Ricardo Rios Nascimento
3   Centro Universitário São Camilo, Ipiranga, SP, Brazil
,
Lerud Frosi Nunes
4   Orthopedics and Traumatology Institute, Vitória Apart Hospital, Serra, ES, Brazil
,
Rudi Natalli Montenegro
4   Orthopedics and Traumatology Institute, Vitória Apart Hospital, Serra, ES, Brazil
,
Jorge Luiz Kriger
4   Orthopedics and Traumatology Institute, Vitória Apart Hospital, Serra, ES, Brazil
,
Bernardo Garcia Barroso
4   Orthopedics and Traumatology Institute, Vitória Apart Hospital, Serra, ES, Brazil
› Author Affiliations
Further Information

Publication History

08 December 2018

10 February 2019

Publication Date:
02 April 2019 (online)

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Abstract

Introduction The pisiform bone is the fourth bone of the proximal row of the carpal bones, and it is located in the tendon of the flexor carpi ulnaris muscle, being considered a sesamoid bone. Traumatic dislocation of the pisiform bone is a rare condition, which usually results from a trauma in dorsal flexion of the wrist. Its treatment can be conservative or surgical, ending or not with the removal of the pisiform bone.

Objective To report a case of a child who fell from his own height and presented wrist pain, diagnosed with dislocation of the pisiform bone. We emphasize the importance of anatomy knowledge in the evaluation of wrist trauma.

Case Report The anamnesis confirmed that the fall occurred with the wrist in hyperextension. The physical examination showed a slight limitation of movement due to pain. Radiographic exams and a computed tomography (CT) scan of the wrist were performed, in which an anterior deviation/luxation of the pisiform bone was evidenced. A conservative treatment with plaster immobilization for analgesia was performed for 1 week. As there were no symptoms and no signs of trauma consistent with the images, such as edema and local ecchymosis, in addition to the early complete disappearance of pain, the responsible team proposed the hypothesis of asymptomatic chronic dislocation of the pisiform bone.

Conclusion Imaging exams in orthopedic traumatology are fundamental for an accurate diagnosis. Nevertheless, they must be associated with knowledge of the anatomy to correlate the image findings with the anamnesis, leading to a better understanding of silent, asymptomatic, and preexisting conditions in the clinical practice.

Keywords

anatomy - pisiform bone - trauma - dislocation
 

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