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At least 19 recordsLinked to original sources
PubMed1996

Circular arterial supply of the pisiform bone.

The arterial vascularization of the pisiform bone was studied from 15 cadavers to assess the possibility of pedicled pisiform transfer in Kienböck's disease. The arterial vascularization of the pisiform bone comes from three pedicles: an upper pedicle arising from the dorsal carpal artery, a lateral pedicle arising from the ulnar artery, and a lower pedicle arising from the deep palmar branch of the ulnar artery. The pisiform bone is well vascularized and, whatever the distribution of the pedicles within the bone itself, we always found an arterial circle around it. The lengths of the upper and lower pedicles expressed as ratios of the length or width of the pisiform bone were variable, as indicated by the coefficient of variation that was greater than 36%. There was no significant correlation between the length of the upper or lower pedicle and the length or width of the pisiform bone. The length of the upper pedicle, which was greater than the distance between the origin of the dorsal carpal artery and the center of the lunate, allows a pedicled pisiform transfer in Kienböck's disease. Nevertheless, it is difficult to assert definitively that the upper pedicle is sufficient to avoid a partial necrosis of the pedicled pisiform bone.

Aged↗
PubMed1979

[Functional anatomy of the pisiform bone].

The pisiform is the only moving structure of the canalis carpi. In the power grip, it undergoes a posterior and medial movement, limited by the pisohamate ligament. This motion is indispensable for a good prehension. The strength of the pisohamate ligament effectively balances the dislocation tendency the flexors carpi ulnaris exert on the pisiform.

Biomechanical Phenomena↗
PubMed1996

[Transplantation of pedicled pisiform bone to replace lunate bone with aseptic necrosis].

OBJECTIVE: To find out a new and effective method for the treatment of aseptic necrosis of lunate bone. METHODS: Blood supply and morphology of pisiform bone were investigated in 25 upper limbs and 57 sets of carpal bone from adult cadavers on the basis of anatomical study. The lunate bone was replaced with pisiform bone of pedicled blood vessel and tendon of musculus flexor earpiulnaris in 17 patients with aseptic necrosis of lunate bone (stage III). RESULTS: The patients were followed up for 18-46 months (average of 28 months). Complete relief of pain was obtained in all of the patients, and the range of motion of their wrists was improved. Grip strength was increased by 48.2%. Radiograph showed normal location of transferred pisiform bone without osteosclerosis and atrophy in 16 patients. Atrophy of pisiform bone was found 2 years after operation in one patient. In the 17 patients, 15 resumed their original jobs and 2 changed their jobs for other reasons. CONCLUSION: We consider that the carpal bone chain can be completely preserved by transplantation of pedicled pisiform bone, which it is an effective method to treat aseptic necrosis stage III of lunate bone.

Adult↗
PubMed1984

Wrist flexion strength after excision of the pisiform bone.

Diseases of the pisiform triquetral (P-T) joint and the pisiform itself are often treated with excision of the pisiform bone. The flexor carpi ulnaris (FCU) tendon inserts on the volar aspect of the pisiform, suggesting a loss of strength in wrist flexion following excision of the bone. Isometric and dynamic, isokinetical measurements were made using a strain-gauge dynamometer (Cybex II). Slight postoperative reduction of wrist flexion strength, compared with the contralateral wrist, was noted but not of clinical significance. It is concluded that one should not refrain from excision of the pisiform bone for fear of considerable strength loss in wrist joint flexion.

Aged↗
PubMed1996

[The pisiform bone: sesamoid or carpal bone?].

In man, the pisiform bone occupies an unusual place among the carpal bones. It is situated in an anterior plane to the other bones, sheathed within the tendon of the flexor carpi ulnaris, and ossifying almost four years the last of the carpal bones. Many theories have tried to explain the presence of this "exceptional" bone: the first theory, proposed by Flower and Mivart, suggested the possibility that this bone could be a sesamoid. The second theory supposes a polydactyl hand, assuming that polydactyly preceded pentadactyly; the pisiform would then be a post-minimus vestigial bone according to Bardeleben. Finally, Gegenbauer and Gillies, proposed a primary pentadactyl hand in which the carpus would be composed of three proximal elements, generally two central, and five distal. The pisiform would either be a derivative of the central series, or a distinct element in the carpus. This last theory appears to be the most likely. The primary carpus would therefore have consisted of 12 bones arranged in 3 distinct rows, a proximal row of 3 bones, a central row of 4 bones, and a distal row of 5 bones. According to this theory, the most ulnar of the central would have been displaced to the medial limit of the carpus, to become the pisiform.

Animals↗
PubMed1983

[Traumatic luxation of the pisiform bone].

Dislocation of the pisiform bone is very rare. One case of such a dislocation is reported and discussed, the previous literature and treatment are reviewed. The purpose of this report is to remark the advantages of the primary operation (removal of the Os pisiforme).

Adolescent↗
PubMed1994

[Fracture of the pisiform bone].

Fractures of the pisiform bone are rare compared with the other carpalia. Diagnosis is difficult because of the complicated anatomic structure of the carpalia, and is facilitated by detailed clinical findings, special x-ray takes and precise knowledge of the history and course of the relevant accident.

Carpal Bones↗
PubMed1998

MRI follow-up of pisiform bone transposition for treatment of lunatomalacia.

OBJECTIVE: Transposition of the pisiform bone is an operative treatment for lunatomalacia. The postoperative viability of the transposed pisiform bone is difficult to assess. The purpose of the study was to evaluate the utility of MRI for postoperative assessment of viability of the pisiform and lunate bones. DESIGN AND PATIENTS: Six patients who underwent transposition of the pisiform for treatment of lunatomalacia, were assessed pre- and postoperatively with conventional radiographs (including tomography), CT and MRI. RESULTS: Conventional radiographs, conventional tomograms and CT were all useful in demonstrating the location of the transposed pisiform. CT showed the transposed pisiform without superposition. However, neither CT nor conventional techniques provided information regarding viability of the pisiform. In all patients investigated in the first year following surgery, T1-weighted MR images showed high signal intensity in the transposed bones. In all patients investigated after 1 year, the signal intensity decreased to an intermediate level on T1-weighted images. Enhancement following contrast medium administration in the transposed pisiform and the lunate was noted in all patients, indicative of viability. CONCLUSION: Contrast-enhanced MRI is able to provide important information regarding the viability of the transposed pisiform and the remaining parts of the lunate. Thus, contrast-enhanced MRI provides an improved means of postoperative assessment regarding short-term follow-up following pisiform transposition. In the long-term follow-up conventional radiography and CT may be equal to MRI in showing increasing sclerosis and/or fragmentation.

Adolescent↗
PubMed2002

[Dislocation of the pisiform bone. A review of the literature].

Dislocation of the pisiform bone is extremely rare. So far, only 25 cases proved by radiographs have been reported. The sturdiness and stability of its ligamentous attachments may explain why dislocations of the pisiform are so rare. Often the dislocation is the result of direct trauma to the palmar and ulnar aspect of the wrist and less frequently due to indirect force or forceful muscular contraction. Dislocation of the pisiform bone occurs predominantly in young and active males. Usually, the pisiform is dislocated proximally or distally. The diagnosis is made by plain radiography. Operative treatment with pisiform excision and meticulous reapproximation of the attached soft-tissue structures yielded the most reliable results with preservation of wrist-flexion strength. Thus, although being very heterogenous with regard to mechanism of injury and displacement, pisiform dislocations should receive uniform treatment to obtain predictable results.

Carpal Bones↗
PubMed2003

Dislocation of the pisiform bone after severe crush injury to the hand.

The pisiform bone dislocated in a 56-year-old worker who had a crush injury of his wrist. Open reduction and reconstruction of the ligaments resulted in proximal subluxation of the pisiform bone and post-traumatic arthritic changes. Other authors recommend that excision of the pisiform is considered to be a more appropriate method of treatment.

Carpal Bones↗
PubMed1993

[Extirpation of the pisiform bone: indications and results].

We have treated 26 patients with pain around the pisiform bone. From this experience, we have attempted to define diagnostic criteria and a therapy rationale. The diagnosis was made from clinical, radiographical and scintigraphic data. Therapy consisted of denervation combined with extirpation alone, or arthrodeses. The results correlated with the etiology of the pisiform bone pathology. The outcome in patients with idiopathic arthrosis and in patients with instability was good; the result was fair in patients with insertion-tendinitis of the flexor carpi ulnaris. In patients with posttraumatic arthrosis the results were unsatisfactory; however, the number of patients in this last group was small.

Adult↗
PubMedDate not supplied

[Cortical hyperostosis of the pisiform bone in stage I Dupuytren contracture in chronic alcoholics].

The author examined the carpalia of 40 male alcoholics suffering from Stage I of Dupuytren's contracture. In four subjects he observed a cortical hyperostosis of the right pisiform bone on the tangential films. The hyperostosis can be ascribed to the ethanol-induced hyperlipoproteinemia type II/B. The lipoids leaving the vascular paths infiltrate the connective tissue capsule of the pisiform bone and stimulate the formation of osteoblasts at the border between bone and soft tissue. The ossification must be regarded as enteropathic hyperostosis.

Adult↗
PubMed1984

[Arthrosis of the articulation of the pisiform bone].

Osteoarthritis of the pisiform at its articulation with the triquetral bone is rarely reported in the literature. Four cases are presented with involvement of both hands in one. The diagnosis can be verified by clinical examination and X-rays. The method of treatment selected was arthrodesis by means of wire suture.

Arthrodesis↗