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Intermediate Technical IVT

pisiform excision

Surgical removal of the pisiform bone, typically performed for pisotriquetral arthritis or pisiform fractures.

Full Definition

Pisiform excision is a surgical procedure involving removal of the pisiform bone, one of the eight carpal bones located on the ulnar aspect of the wrist. This procedure is most commonly indicated for symptomatic pisotriquetral arthritis, chronic pisiform fractures, or pisiform subluxation that has failed conservative management. The pisiform serves as a sesamoid bone within the flexor carpi ulnaris tendon and provides mechanical advantage for wrist flexion, but its removal typically results in minimal functional deficit. The surgery is performed through a small incision over the pisiform, with careful attention to protecting the nearby ulnar nerve and artery in Guyon's canal. Postoperative rehabilitation focuses on regaining wrist motion and strength while protecting the healing flexor carpi ulnaris tendon insertion.

Usage

Usage note: Can be termed pisiform excision or pisiformectomy; specify indication when documenting procedure.

In Context

  • "Pisiform excision provided complete resolution of the patient's ulnar-sided wrist pain." — Follow-up note
  • "The procedure involved careful pisiform excision while preserving the flexor carpi ulnaris tendon insertion." — Operative report

Also known as

pisiformectomy

Contrasted with

pisiform preservation

Don't confuse with

hook of hamate excision TFCC debridement

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