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Pisiform impingement after total wrist arthroplasty
Sean T Johnson1, Amar Patel, Ryan P Calfee
1Department of Orthopaedics, Brown Medical School, Rhode Island Hospital, Providence, RI, USA.
The Journal of Hand Surgery
|March 6, 2007
Summary
A total wrist arthroplasty can cause ulnar-sided wrist pain due to pisiform erosion. Pisiform excision effectively resolves this pain, highlighting the need for careful implant placement during surgery.
Area of Science:
- Orthopedic Surgery
- Rheumatology
- Hand Surgery
Background:
- Rheumatoid arthritis often necessitates surgical interventions like total wrist arthroplasty.
- Total wrist arthroplasty aims to restore function and alleviate pain in patients with severe wrist arthritis.
Observation:
- A 64-year-old woman with rheumatoid arthritis experienced persistent ulnar-sided wrist pain three years post-total wrist arthroplasty.
- The pain was attributed to the erosion of the pisiform bone, a component of the wrist's carpal bones.
Findings:
- Surgical excision of the eroded pisiform provided complete symptom resolution.
- This case suggests a potential complication of total wrist arthroplasty involving the pisiform bone.
Implications:
- Careful consideration of carpal component placement is crucial to prevent impingement or overhang into the pisotriquetral joint.
- This surgical technique may help prevent or manage ulnar-sided wrist pain following arthroplasty.
