Isolated Compound Dislocation of the Pisiform Bone with Associated Neurovascular Injury Following an Assault: A Rare Injury Pattern.

Abstract

Introduction: Isolated pisiform dislocation is a rare form of carpal bone dislocations. It is usually associated with a violent pull of the flexor carpi ulnaris tendon or a sudden dorsiflexion of the wrist. The management varies from conservative treatment to complete excision of the bone. However, a consensus has not yet been established about the management.

Case report: We present a case of isolated fracture dislocation of the pisiform bone following an assault with a sharp object. Injury to the ulnar neurovascular bundle in the Guyon's canal was noted. The bone was fixed with K wire followed by repair of the neurovascular structures. There was good functional recovery after the repair. The mode of injury and the associated neurovascular injury make this report unique.

Conclusion: Fixation of certain fracture dislocation plays a major role in the improvement of functional outcomes when compared to conservative management.