Dysfunction of the pisotriquetral joint: degenerative arthritis treated by excision of the pisiform

From 1995 to 2000, 21 patients (14 women and 7 men) with a mean age of 42 were treated with excision of the pisiform for a dysfunction of the pisotriquetral joint. Follow-up ranged from 6 to 36 months (average: 30 months). The diagnoses included degenerative arthritis of the pisotriquetral joint (15 patients), degenerative arthritis associated with a ganglion (3 patients), and calcifications caused by flexor carpi ulnaris tendinopathy (3 patients). All patients had pain secondary to direct pressure on the pisiform. Side-to-side passive motion of the pisiform occasionally led to pain and crepitus. Degenerative arthritis and calcifications in the pisotriquetral joint were confirmed by a wrist radiograph (lateral view in 30 degrees supination). In five patients, local injection with anesthetic temporarily resolved the symptoms. Excision of the pisiform resulted in complete relief of pain without functional deficit.