Causes and risk factors
Like any other fracture, the major cause of pisiform fracture is road accident or vehicle injury. Fall on to the wrist causing severe pressure or force on the bone or direct blow on the ulnar side of the palm with great force can lead to its breakage. Indirect trauma can also lead to pisiform fracture. Hyperextension with great force can lead to its dislocation. Microtrauma as a result of repeated force or trauma is another contributing factor seen.
Clinical presentation:
Pain is a prominent feature seen. Along with this, swelling and bruising are the other complaints. Pain is especially seen at the ulnar aspect of the wrist. Weak grip is complained by the patient. On examination, tenderness is present.
Investigations:
Considering the symptoms, a local examination is carried out by the orthopedic doctor. There is often a history of injury. X-ray of the carpal bones is sufficient for diagnosis. If required, a CT scan can be done.
Treatment:
Rest, elevation of the arm, and application of ice pack are the essential steps to be implemented. Analgesic or non-steroidal anti-inflammatory drugs are advised by the orthopedic doctor for relief of the pain. Short arm cast is applied for immobilization for 6-8 weeks. Usually the conservative method of treatment gives an effective result. As recovery starts, certain physiotherapy exercises are advised under the guidelines of a trained physiotherapist.
Other Modes of treatment:
Certain other modes of treatment can also be helpful in coping up with the symptoms. Taking into consideration the symptoms in a holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints. Certain yoga exercises can also be helpful in strengthening of the muscles.
