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The effect of pisiform excision on wrist function.

J van Eijzeren1, R P Karthaus1

  • 1Department of Orthopaedic Surgery, Medisch Spectrum Twente Hospital, Enschede, The Netherlands.

The Journal of Hand Surgery
|May 28, 2014
PubMed
Summary

Pisiform excision for pisotriquetral joint pain is safe and well-tolerated, though it may lead to reduced wrist extension. Patients reported functional impairments, but objective measures showed few differences compared to controls.

Keywords:
Excisionpisiformretrospectivewrist function

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Area of Science:

  • Orthopedic Surgery
  • Hand and Wrist Surgery
  • Musculoskeletal Research

Background:

  • Pisotriquetral joint pain, often due to arthrosis, can be refractory to conservative management.
  • Pisiform excision is a surgical option for persistent pisotriquetral joint pain.

Purpose of the Study:

  • To evaluate the functional outcomes of pisiform excision.
  • To compare wrist function in patients who underwent pisiform excision with age- and sex-matched controls.

Main Methods:

  • Retrospective chart review of 11 patients undergoing pisiform excision.
  • Clinical examination and functional assessment of 9 patients and 9 matched controls.
  • Measurements included range of motion, strength, neurological status, and validated questionnaires (DASH, MHQ).

Main Results:

  • Operated wrists showed reduced extension compared to controls.
  • Significant differences were observed between patients and controls on the Disabilities of the Arm, Shoulder, and Hand (DASH) and Michigan Hand Outcomes Questionnaires (MHQ).
  • Subjective patient-reported functional impairments were noted, but objective findings were largely similar between groups.

Conclusions:

  • Pisiform excision is a safe and well-tolerated surgical treatment for refractory pisotriquetral joint arthrosis.
  • Careful handling of surrounding soft tissues during surgery is crucial.
  • While patients may perceive functional deficits, objective outcomes are comparable to controls in most aspects.