PISOTRIQUETRAL LOOSE BODIES

Eight patients--2 men and 6 women (mean age, 49 years)--who underwent excision? of pisotriquetral (PT) loose bodies were identified from cli nic records. The time interval ii-om onset of symptoms to surgery aver aged 18 months. Four patients reported a traumatic onset of symptoms, and 4 reported an insidious onset. For all patients, treatment by nons teroidal anti-inflammatory drugs, splinting, and steroid injection had failed. Routine radiography revealed a loose body in only 4 patients. Trispiral tomography delineated ail loose bodies. Three patients unde rwent loose-body excision only; 5 had PT joint degeneration and underw ent went additional pisiformectomy. Length of follow-up monitoring ave raged 7.4 years. Ali patients had resolution of wrist pain and improve ment in strength. There were no complications. Loose bodies, which may form in the PT joint or migrate from the radiocarpal joint, were iden tified best by tomography, with simple excision providing excellent re lief of symptoms in the absence of PT joint degeneration.