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Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Prateek Behera, Karthick Rangasamy, Nirmal Raj Gopinathan
The ulnar nerve is marked by connecting the following two points: The first point is behind the base of the medial humeral epicondyle.The second point is marked laterally to the pisiform bone.
Upper Limb
Published in Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden, Human Sectional Anatomy, 2017
Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden
The pisiform bone (20) can be considered as a sesamoid within the termination of the tendon of flexor carpi ulnaris (23), which anchors via the pisohamate ligament to the hook of the hamate and via the pisometacarpal ligament to the base of the fifth metacarpal bone.
The Antebrachium
Published in Gene L. Colborn, David B. Lause, Musculoskeletal Anatomy, 2009
Gene L. Colborn, David B. Lause
The flexor carpi ulnaris muscle lies upon the ulnar border of the forearm, taking much of its origin from the subcutaneous border of the ulna. Distally, it inserts partially into the pisiform bone and other adjacent bones and ligamentous elements. The pisiform bone is one of the smaller bones of the wrist (carpus). You can palpate the pisiform bone as the hard little structure at the medial border of the wrist, just beyond the distal flexor crease of your wrist.
Ultrasonography for carpal tunnel syndrome in pregnancy: a prospective cross-sectional study
Published in Journal of Obstetrics and Gynaecology, 2022
Sule Goncu Ayhan, Egemen Ayhan, Ali Turhan Çaglar, Dilek Sahin
In this study, all USG measurements were done by the same perinatologist after a brief education by a hand surgeon, who uses USG regularly in his daily practice. In a recent study (Crasto et al. 2019), inexperienced ultrasound operators displayed acceptable levels of accuracy in imaging the carpal tunnel after 5 minutes of teaching by an experienced hand surgeon. The distal wrist crease and pisiform bone are obvious landmarks and the median nerve is superficial with a honeycomb appearance (Figure 2). The MN-CSA at this carpal tunnel inlet level is the most commonly measured and most reliable level for sonographic diagnosis of CTS (Buchberger et al. 1992; Duncan et al. 1999; Yesildag et al. 2004; Alemán et al. 2008; Visser et al. 2008; Roll et al. 2011; Cartwright et al. 2012; Tai et al. 2012; Junck et al. 2015; Chen et al. 2016; Ažman et al. 2018). Obstetricians are expert ultrasonographers and we think they will have no trouble learning to measure MN-CSA at the wrist after a short education.
Acute ulnar nerve compression associated with pisiform fracture – a case report and literature review
Published in Case Reports in Plastic Surgery and Hand Surgery, 2019
Min Kai Chang, Robert Tze Jin Yap
Howard [6] advocated that immobilization may not be necessary initially, but if prompt recovery of nerve function is not apparent, the ulnar nerve should be explored in six to eight weeks. He presented a case of displaced pisiform fracture with immediate active mobilization; at six months’ follow-up, there is recovery of the strength of the first interosseous muscle, but Tinel’s sign is still positive and span of right hand continues to be diminished. Israeli et al. [7], on the other hand, presented one case of pisiform fracture with ulnar nerve compression that was immobilized with plaster for 3 weeks, followed by 3 weeks of rest. At three weeks’ follow up, there was complete neurological and functional recovery with mild effort induced pain in the hypothenar area. Matsunaga et al. [9] explored the distal ulnar tunnel with excision of entire pisiform bone for two cases: one non-union of pisiform fracture and one comminuted fracture; at 19 and 21 months’ follow-up respectively, there was slight numbness in the ring and little fingers for one of the cases, but no weakness of the intrinsic muscles in both cases. Agathangelidis et al. [1] presented a case of open pisiform fracture that was managed by internal fixation with cerclage. At 14 weeks, there was complete fracture union, and at 6 months’ follow-up, there was painless motion with ‘acceptable degree of hand function’, but no indication in the recovery of the ulnar nerve. These reports demonstrated the range of therapeutic options with varied results.
Vascularized bone graft from the second metacarpal base for trapeziometacarpal joint arthrodesis
Published in Case Reports in Plastic Surgery and Hand Surgery, 2018
Akito Nakanishi, Kenji Kawamura, Shohei Omokawa, Takamasa Shimizu, Yasuhito Tanaka
The first vascularized pisiform bone graft was reported in 1971 [6]. Hori et al. then successfully performed vascular bundle implantation to necrotic bone [1]. Following these publications, transfer of a live bone graft with its nutrient vascular pedicle was performed with satisfactory clinical outcomes in patients with recalcitrant nonunion or osteonecrosis. Makino reported a case in which a vascularized second metacarpal base bone graft was successfully used to treat scaphoid nonunion and Kienböck’s disease [2]. We used this procedure to obtain early and reliable bone union in arthrodesis of the TMC joint in three cases.