[Treatment of piso-triquetral pain by excision of the pisiform: report of fifteen cases]. / Traitement des douleurs piso-triquétrales par exérèse du pisiforme: à propos de 15 cas.

ABSTRACT

INTRODUCTION: Piso-triquetral joint could be painful and pisiformectomy can be the best procedure if conservative treatment have failed. The aim of this retrospective study was to evaluate clinical and functional results of pisiformectomy. MATERIAL AND METHOD: Thirteen patients with pisiformectomy were included in this retrospective study, 2 of them have bilateral procedure (n = 15). An ulnar neuropathy was associated in four cases. The average follow-up was 31.5 month. Professional traumatic injuries were the most common etiology. Surgical procedure was the same for all patients. Patients were reviewed clinically and subjective results were evaluated with an analogic scale (Eva). RESULTS: No postoperative complications were found. At the maximal follow-up, result was excellent for 12 cases, good for 2 cases and fair for one case. Analogic evaluation pain at maximal follow-up was 0.8 points compared to 6.4 points preoperatively (p < 0.001). Wrist range of motion was improved. DISCUSSION: Etiologies of piso-triquetral disorders were large and dominated by traumatic or microtraumatic injuries. Pisiformectomy is the best procedure if conservative treatment have failed. There is no place for piso-triquetral arthrodesis considering pisiformectomy's good results. Nevertheless, it's important to know that piso-triqueral disorder could be included in an authentic loco-regional disorder.