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At least 19 recordsLinked to original sources
PubMed1998

[Movements of the pisiform and triquetrum bones and their significance for kinematics of the ulnar wrist].

The purpose of this study is to investigate carpal kinematics with respect to the pisotriquetral joint, before and after pisi-form excision. Five cadaver-hands were studied and a custom-designed plexi-glass-fixation device was used to standardize the wrists for exact passive movements in flexion and extension as well as in ulnar and radial abduction. Five sets of motion were registered before and after excision of the pisiform. Motion of the triquetrum and pisiform were studied by 3D-Motion Analysing Software System (peak 54). The results indicated that the excision of the pisiform does have an influence on the kinematics of the wrist. The movement of the triquetrum was increased after removal of the pisiform. Although the differences in measurement were only a few of millimetres and degrees, we know from the dorsal and palmar intercalated segment instabilities that even minor instabilities can act as a predisposing factor for arthrosis. Therefore, the excision of pisiform must be carefully considered. The common joint between the triquetrum and pisiform supports and indicates relation of their movements. However, the correlation for flexion/extension and radial deviation was high, an obvious correlation of the movements for ulnar deviation was not verifiable.

Biomechanical Phenomena↗
PubMed1993

Kinematics of the wrist and its ligaments.

Precise anatomic dissections of unembalmed physiologically intact cadaver specimens were carried out before proceeding with the kinematic investigations on further specimens. Carpal flexor and extensor tendons were used to move the wrist. The analysis of the carpal bone movements was performed according to the finite helical axis motion concept for increments of 10 degrees for each main carpal motion. Separate axes of rotation for each of the bones in the proximal carpal row were found; however, the axes for the lunate and triquetrum bones were close, and the magnitudes of rotation and translation almost equal. One finding was that the axes of rotation of the bones in the proximal carpal row often cross at some particular point. Because the axes of the scaphoid are differently oriented than those of the lunate and triquetrum, shear might occur during wrist motion. This indicates also that the scaphoid and lunate cannot be considered rigidly coupled elements. We also assume that the individual bones of the proximal carpal row self-align themselves as long as they are not constrained by torsion. Several potential mechanisms of flexion motion of the proximal carpal row during radioulnar deviations of the hand were considered. The ligament function is still an unsolved problem. Compensation mechanisms may mask clear correlations between a lesion and the instability pattern associated with it. The proximal carpal row should be studied as one system.

Cadaver↗
PubMed1979

The dorsal arterial network of the wrist with reference to the blood supply of the carpal bones.

The gross examination of 50 minium injected specimens showed us the various patterns of the posterior arterial network of the wrist. This is chiefly provided by the radial artery which gives off a constant dorsal carpal branch over the posterior aspect of the trapezium. This vessel crosses the carpus transversely to the inner border of the hand and is joined in half of the cases by the interosseous artery; contribution of the posterior carpal branch of the ulnar artery was more rarely found than usually described (25%). From the arch thus formed are given off short branches which run upwards along the intercarpal joints and enter the posterior aspects of the proximal carpal bones whose lower halves seem to be the most favorably supplied. On the contrary, the distal carpal bones receive several short twigs which penetrate their posterior surfaces. Although the arrangement of the pedicles may undergo many a variation, attention must be drawn to the fact that the dorsal arteries are smaller but denser than the volar, except for the hamate. Therefore 2 different patterns of arterial supply can be described at the carpus: the blood supply of the outer and axial bones--scaphoid, trapezium, lunate, capitate--derives from the radial and the interosseous arteries and is probably shared equally by volar and dorsal branches; the inner bones--triquetrum, hamate--are primarily supplied by volar or medial branches coming almost exclusively from the ulnar artery.

Adult↗
PubMed2002

[Isolated transverse fracture of the os triquetrum. Case report of a rare injury].

With the case of a 25 year old patient we will report of a rare injury, the isolated body fracture of a triquetrum bone. This kind of injury often happens in dorsalflected and ulnarducted hand position because of the anatomical position of the triquetral bone. The therapy of choice is conservative treatment with a volar splint for three to six weeks. Operation is only necessary in case of dislocation of a fragment [4]. Complications as an aseptic necrosis of a fragment is not reported. We found only one case of a pseudarthrosis [5]. Even in our case occurred a complete healing of the bone and a complete functional remission.

Adult↗
PubMed2006

Pisotriquetral arthrodesis as an alternative to excision for pisotriquetral instability in high-demand patients: a case report in a gymnast.

UNLABELLED: A gymanast developed ulnar wrist pain caused by pisotriquetral instability. Pisotriquetral arthrodesis resulted in pain relief and sufficient functional return to allow her to return to gymnastics. Pisotriquetral arthrodesis is a feasible alternative to pisiform excision worth consideration in high-demand patients with symptomatic pisotriquetral instability or arthrosis. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic, Level V.

Adolescent↗
PubMed1979

[A case report: pseudarthrosis of the os lunato-triquetrum?].

The reported case is in its development, diagnostic, course, and legal aspect so extraordinary, that an explicit report is justified. The patient complained of pain in his right wrist region some days following an unusual work with a drilling machine for eight days. The X-rays six months later showed an irregular joint space between the lunate and triquetrum bone, while on his left wrist a synostosis between these bones was found. These changes seemed to be suspicious for a pseudarthrosis of a congenital synostosis, but this diagnosis led to a six years' controversy in several legal procedures. The different interpretations (judgements) by the attending doctors, specialists, and judicial experts, show again the importance of an exact early documentation with sufficient primary X-rays, eventually with comparison of the other hand. During treatment, nothing should be left undone which could support or refute especially an unusual diagnosis.

Adult↗
PubMed1986

Erosion of the triquetrum and pisiform bones caused by a foreign body granuloma.

A 16-year-old boy had pain and swelling in the left wrist 6 months after he had fallen on a twig. Erosion of the triquetrum and pisiform was seen on x-ray films. A granulomatous process was identified at operation. Despite numerous cultures and special stains, no organisms were identified. Wood debris was seen under high-power magnification. A wooden foreign body may cause bone and joint destruction through a granulomatous process. In this case, surgical debridement and excision stopped the destructive process.

Adolescent↗
PubMed2006

Pisotriquetral arthrosis after triquetral malunion: a case report.

We report a patient with chronic ulnar palmar wrist pain caused by malunion after isolated fracture of the triquetrum. Intra-articular malunion of the triquetrum body resulted in posttraumatic pisotriquetral arthrosis. The diagnosis was made by magnetic resonance imaging, computed tomography, bone scintigraphy, and wrist arthroscopy 5 months after the injury. The patient's symptoms were relieved by excision of the pisiform.

Adult↗