Surgical Management of Pisiform Bone Deformity Associated with Tendonitis of Flexor Carpi Ulnaris

Abstract

Wrist pain is the most commonly reported complaint during everyday activity, and a wide range of factors may cause the wrist pain. A precise assessment of the cause of wrist pain, as well as an accurate diagnosis, is essential in appropriate management of wrist pain. One cause of wrist pain includes pain around the pisiform bone due to tendonitis of flexor carpi ulnaris, mostly caused by overuse of muscle or bone fracture. A carpal tunnel Xray view of the patients complaining of pain at the pisiform bone shows bone widening and calcification (Fig. 1), similar to that seen in bone widening of the calcaneus in Haglund deformity. Haglund deformity is a disease caused by bone widening at the posterior site of the heel; the widening causes friction at the soft tissue surrounding the Achille’s tendon, resulting in aggravation and inflammation. Similarly, patients with wrist pain who show calcification of the pisiform bone-we said pisifor deformity-on X-ray and who reports either direct tenderness or pain upon wrist flexion or ulnar deviation may be considered to have pathophysiology equivalent to Haglund deformity. Therefore, it is plausible to consider the removal of the widened bone-the protruded or calcified site of the pisiform bone-as a treatment reducing the pain. This Surgical Management of Pisiform Bone Deformity Associated with Tendonitis of Flexor Carpi Ulnaris