Pisiform area pain treatment by pisiform excision

Thirty-three patients with pisiform area pain have been treated. Of these, the pisiform bone was excised in 21 patients who had intractable pisiform bone pain that was not relieved by the conservative methods of immobilization, local steroid injection, and anti-inflammatory medication. The indications for excision were painful union or nonunion of pisiform fractures, pisiform-triquetrial arthritis, and tendonitis of the flexor carpi ulnaris (FCU) insertion. Wrist strength and mobility was maintained by doing a subperiosteal dissection and removal of the pisiform bone. This technique preserves the insertion of the FCU tendon and its distal extension, the piso hamate and the piso metacarpal ligaments.