Pisiform Fracture Test

What is a pisiform bone?

The pisiform bone, a small pea-shaped carpal bone, is situated at the base of the palm on the ulnar (pinky finger) side of the wrist. This bone, part of the eight carpal bones, is crucial for wrist stability and movement. It is linked to the triquetrum bone by a ligament and can articulate with the hamate bone. The pisiform bone protects the ulnar nerve along its palmar surface.

Damage or breakage of this bone can result in complications affecting the ulnar nerve, leading to wrist fractures, ulnar nerve injury, or the need for surgical excision. This bone is also associated with adjacent carpal bones, sesamoid bone, wrist injuries, wrist splints, and upper extremity fractures.

What are pisiform fractures?

Pisiform fractures are carpal fractures involving the pisiform bone. They can be caused by direct trauma or repetitive stress on the wrist, such as in sports activities like baseball, gymnastics, and rock climbing.

Symptoms of pisiform fractures

Symptoms of pisiform fractures may include:

• Swelling and tenderness on the ulnar side of the wrist
• Difficulty or pain with gripping and grasping objects
• Weakness in the pinky finger muscles
• Numbness or tingling in the ring and little fingers (signs of ulnar nerve palsy)

Individuals may also experience chronic wrist pain, especially with movements that involve ulnar deviation (bending the wrist towards the pinky side).

Risk factors and causes of pisiform fractures

Pisiform fractures are most commonly seen in young athletes due to the repetitive stress on the wrist during sports activities. Other risk factors for pisiform fractures include:

• Falls onto an outstretched hand, particularly with an impact on the ulnar side of the wrist
• Direct trauma to the pisiform bone or surrounding area
• Osteoporosis (weak and brittle bones)
• Arthritis or other degenerative joint conditions

What is a Pisiform Fracture Test?

Although not widely standardized for diagnosing pisiform fractures, the Pisiform Fracture Test involves palpating the medial aspect of the wrist where the pisiform bone is situated.

To perform the test, the healthcare examiner applies gentle pressure on the pisiform bone located near the pinky finger, moving it in a circular motion. Then, the patient is asked to bend and extend their wrist while assessing for any pain.  The test is repeated on the other wrist for comparison, noting any tenderness, swelling, or clicking sounds.

Apart from manual palpation, healthcare providers may utilize various imaging techniques, such as X-rays, computerized tomography (CT) scans, or magnetic resonance imaging (MRI) to precisely confirm the diagnosis of a pisiform fracture. These imaging modalities play a crucial role in determining the fracture's exact location, type, and severity while also assessing any accompanying injuries or complications that may impact the treatment plan.

How to use our Pisiform Fracture Test template

Carepatron has created a simple and easy-to-use Pisiform Fracture Test template to streamline your clinical documentation. Follow these steps to get started:

Step 1: Download the template

Use the link on this page to download a copy of the printable Pisiform Fracture Test form. You may also download it from the Carepatron app or our resources library.

Step 2: Print or use the digital format

You can either print the template and keep it in your physical files or use the digital format available on our app. The digital version allows you to save, access, and edit your documentation easily.

Step 3: Fill out the form during the examination

During a patient's initial assessment or follow-up appointment, fill out the template by inputting relevant information, such as the patient’s name and date.

Step 4: Perform the pisiform fracture test

Follow the instructions outlined in the template to examine the pisiform bone thoroughly. During palpation, note any tenderness, swelling, or clicking sounds.

Step 5: Record results and findings

Record your observations and results from the examination in the designated sections of the template. This will serve as a clear record of your assessment for future reference.

Step 6: Conduct imaging or further tests

If necessary, conduct imaging or further tests to confirm the diagnosis and extent of the fracture. You can also use the template to record and include these results in the patient's file.

Step 7: Save and share

Save a copy of the completed template for your records and easily share it with other healthcare professionals involved in the patient's care. This will ensure everyone is on the same page regarding the diagnosis and treatment plan.

Pisiform fracture treatments

Treatment options for pisiform fractures may vary depending on the type and severity of the fracture, as well as any accompanying injuries or conditions. Some common treatment methods include:

• Immobilization: For non-displaced or minimally displaced fractures, a splint, cast, or brace may be used to keep the wrist in a stable position while it heals.
• Medications: Pain relievers and anti-inflammatory medications may be prescribed to manage pain and reduce inflammation.
• Physical therapy: Rehabilitation exercises and physical therapy may be recommended to strengthen the wrist and restore range of motion after the fracture has healed.
• Excision of the pisiform: Pisiform excision surgery may be necessary in cases of severe or unstable fractures, or if non-surgical treatments have been unsuccessful.