Abstract
Introduction The pisiform bone is the fourth bone of the proximal row of the carpal bones, and
it is located in the tendon of the flexor carpi ulnaris muscle, being considered a
sesamoid bone. Traumatic dislocation of the pisiform bone is a rare condition, which
usually results from a trauma in dorsal flexion of the wrist. Its treatment can be
conservative or surgical, ending or not with the removal of the pisiform bone.
Objective To report a case of a child who fell from his own height and presented wrist pain,
diagnosed with dislocation of the pisiform bone. We emphasize the importance of anatomy
knowledge in the evaluation of wrist trauma.
Case Report The anamnesis confirmed that the fall occurred with the wrist in hyperextension.
The physical examination showed a slight limitation of movement due to pain. Radiographic
exams and a computed tomography (CT) scan of the wrist were performed, in which an
anterior deviation/luxation of the pisiform bone was evidenced. A conservative treatment
with plaster immobilization for analgesia was performed for 1 week. As there were
no symptoms and no signs of trauma consistent with the images, such as edema and local
ecchymosis, in addition to the early complete disappearance of pain, the responsible
team proposed the hypothesis of asymptomatic chronic dislocation of the pisiform bone.
Conclusion Imaging exams in orthopedic traumatology are fundamental for an accurate diagnosis.
Nevertheless, they must be associated with knowledge of the anatomy to correlate the
image findings with the anamnesis, leading to a better understanding of silent, asymptomatic,
and preexisting conditions in the clinical practice.
Keywords
anatomy - pisiform bone - trauma - dislocation
