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What is the Pisiform?
The pisiform is a bone in the human hand located in the wrist. It is also referred to as the lentiform bone. It is part of a bone cluster called the carpus, which includes several other bones such as the triquetrum, scaphoid and lunate. It is the outermost bone of the carpus, and is located below the pinky finger on each hand.
More specifically, it is located where the ulna, which is the forearm's inner bone that meets up with the carpus cluster. The bone is about the size and shape of a pea — pisiform is Latin for "pea-shaped." Although the bone is very small, it is still a little bit larger than the smallest bone in the body, the stirrup bone located in the ear.
The pisiform is a sesamoid bone, which means it is located within a tendon. In humans most sesamoid bones are found in the hand, foot or knee and they help to increase flexibility and movement. This bone is unique to other wrist bones in that it does not work with other bones in the joints of the wrist. Its sole function seems to be to increase torque and rotation in the wrist and the hand.
The pisiform is rarely fractured in hand injuries. More often other bones in the carpus and proximal row are broken in accidents. Breaks in the pisiform are usually linear fractures and happen most often when the bone is struck directly. Other hand injuries and fractures are usually present when the pisiform is broken. This can lead to injuries of the pisiform bone being overlooked or misdiagnosed, as they are so rare that they are sometimes missed completely by doctors who are focused on more common bone breaks.
Effects of the bone break can be nerve or ligament damage in the surrounding area. Injuries in the hand may also lead to the bone being dislocated, although this is also uncommon. When the bone is injured or broken, wrist and grip strength can be effected.
Often with a break of this bone, treatment includes completely excising it. Leaving the broken bone in the hand usually leads to chronic hand and wrist pain. After the bone is excised the pain usually goes away, and side effects to the removal are marginal. While the wrist, hand and grip strength are adversely effected by its removal, the difference between the wrist with the bone or without without it is usually nominal.
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![Damage to the pisiform bone in the wrist can cause wrist pain.]()
By: GajusDamage to the pisiform bone in the wrist can cause wrist pain. -
![The pisiform is a bone in the human hand that is part of a bone cluster called the carpus, which includes several other bones such as the triquetrum, scaphoid and lunate.]()
By: Anastasia TsarskayaThe pisiform is a bone in the human hand that is part of a bone cluster called the carpus, which includes several other bones such as the triquetrum, scaphoid and lunate. -
![Other hand injuries are usually present when the pisiform is broken.]()
By: mady70Other hand injuries are usually present when the pisiform is broken. -
![Trauma to the wrist may make it difficult to locate the radial pulse.]()
By: joshyaTrauma to the wrist may make it difficult to locate the radial pulse. -
![Injuries of the pisiform are so rare that they can sometimes be missed by doctors who are focused on more common bone breaks.]()
By: waxartInjuries of the pisiform are so rare that they can sometimes be missed by doctors who are focused on more common bone breaks. -
![A break in the pisiform may cause nerve or ligament damage in the surrounding area.]()
By: Photographee.euA break in the pisiform may cause nerve or ligament damage in the surrounding area.
Discussion Comments
After being hit by a flying swing at the school where I work, I have been dealing with wrist pain for four months with nothing that helped. My doctors tried everything from anti-inflammatories to steroid shots. Now this new doc told me that this bone needs to come out. I am looking for how long to expect recovery to take and what are some of the drawbacks to this surgery.
I was told I needed pisoform surgery. I'm a little hesitant because I use my hands for my job. I have persistent pain every day. Is it worth it?
My pisiform bone got fractured during a tornado. Basically, the room where I hunkered down caved in on me, and my wrist got pummeled by bricks.
At first, the doctor tried the standard treatments for pisiform pain. He injected a steroid at the site. When that didn't work, he put me on anti-inflammatory medicine. Still, the pain persisted.
He knew that removing the bone was the only way to stop the pain. Even though it left me a bit weak in the wrist, living without it is better than living with constant pain.
When I was twelve, a mean little boy hit my wrist with a baseball bat as hard as he could. He lived to torture people, and it made him very happy to see me cry out in pain.
Since he hit the bone directly, I had to have pisiform surgery. The doctor removed the bone, and I noticed a significant loss of strength in my hand. I could no longer open tightly sealed jars or do rope climbing at summer camp.
My doctor told me that leaving the bone in would have caused me more pain than having to live without it, so I'm glad they took it out. I have learned to cope with the weakness, and I bought a special grip tool to help me open jars.
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