A 22-year-old professional downhill mountain bike rider developed increasing posttraumatic pisotriquetral instability. To preserve full function of the pisiform bone, we performed pisotriquetral arthrodesis using a Herbert screw. Ten months after the splint was removed, the patient was free of symptoms and returned to professional downhill mountain biking without limitations. This uncommon method seems to be a feasible treatment strategy and can be recommended in high-demand patients.
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