Dorsal and volar wrist ganglions: The results of surgical treatment.

BACKGROUND The wrist, especially its dorsal surface, is the most common location of ganglion cysts in the human body. OBJECTIVES The purpose of this study was to present our experience in the treatment of wrist ganglions and to evaluate the results obtained with the operative management of this type of lesion. MATERIAL AND METHODS A total of 394 patients (289 females and 105 males, aged 10-83 years) treated operatively for wrist ganglions between 2000 and 2014 were included in the study. The results of surgical treatment were evaluated after a minimal 2-year-long follow-up in 69.4% of patients operated on for dorsal wrist ganglions and in 70.6% of patients after the excision of volar wrist ganglions. The shape and size of postoperative scar, range of motion of the wrist, grip strength, severity of pain, and presence/absence of ganglion recurrence were assessed. The influence of demographic factors on the risk of recurrence was statistically analyzed. RESULTS Persistent limitation of wrist palmar flexion was observed in 6 patients after the removal of dorsal wrist ganglions. There were no cases of postoperative grip strength weakening. An unesthetic scar developed in 15 patients after the excision of dorsal wrist ganglions and in 6 patients after the removal of volar wrist ganglions. Postoperative pain was observed in 7 patients with ganglion recurrence and in 17 patients without recurrence. Ganglion cysts recurred in 12.1% of patients treated for dorsal wrist ganglions and in 10.4% of patients operated on for volar wrist ganglions. No influence of patient gender, age, body side, or cyst location on ganglion recurrence was detected. CONCLUSIONS Operative treatment is a widely recognized method of management of wrist ganglions. The rate of resulting persistent complications is low. Recurrence of ganglion cysts is unpredictable and independent of patient demographic factors. It can be observed even in cases, in which a perfect surgical technique has been used.

[1]  K. Iwatsuki,et al.  Patients with benign hand tumors are indicated for surgery according to patient-rated outcome measures. , 2017, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[2]  V. Finsen,et al.  Surgery for ganglia of the flexor tendon sheath , 2013, Orthopedic reviews.

[3]  B. Ollivere,et al.  Predicting successful outcomes of wrist and finger Ganglia. , 2013, Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand.

[4]  A. Weiss,et al.  Arthroscopic Versus Open Dorsal Ganglion Cyst Excision , 2012 .

[5]  J. Craik,et al.  Patient outcomes following wrist ganglion excision surgery , 2011, The Journal of hand surgery, European volume.

[6]  K. Alpantaki,et al.  Ganglionectomy without Repairing the Bursal Defect: Long-term Results in a Series of 124 Wrist Ganglia , 2011, Clinics in orthopedic surgery.

[7]  C. Mathoulin,et al.  Arthroscopic resection of dorsal wrist ganglia: 114 cases with minimum follow-up of 2 years. , 2010, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[8]  P. Ahrens,et al.  Surgical excision of wrist ganglia; literature review and nine-year retrospective study of recurrence and patient satisfaction , 2009, Orthopedic reviews.

[9]  A. Mandal,et al.  Rapidly expanding thenar eminence ganglion: a case report , 2009, Cases journal.

[10]  R. Gelberman,et al.  Ganglia of the hand and wrist: a sonographic analysis. , 2008, AJR. American journal of roentgenology.

[11]  V. Morelli,et al.  Ganglion cysts of the wrist: pathophysiology, clinical picture, and management , 2008, Current reviews in musculoskeletal medicine.

[12]  F. Fanfani,et al.  Articular ganglia of the volar aspect of the wrist: Arthroscopic resection compared with open excision. A prospective randomised study , 2008, Scandinavian journal of plastic and reconstructive surgery and hand surgery.

[13]  J J Dias,et al.  The Natural History of Untreated Dorsal Wrist Ganglia and Patient Reported Outcome 6 Years after Intervention , 2007, The Journal of hand surgery, European volume.

[14]  S. Trigg,et al.  The Use of Routine Wrist Radiography is Not Useful in the Evaluation of Patients with a Ganglion Cyst of the Wrist , 2007, Hand.

[15]  F. Fanfani,et al.  Results and complications in dorsal and volar wrist Ganglia arthroscopic resection. , 2006, Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand.

[16]  C. Dumontier,et al.  [Arthroscopic treatment of dorsal ganglion cyst at the wrist. About 54 cases]. , 2006, Chirurgie de la main.

[17]  R. Singhal,et al.  Ganglion cysts of the wrist : a prospective study of a simple outpatient management. , 2005, Acta orthopaedica Belgica.

[18]  N. Limpaphayom,et al.  Randomized controlled trial between surgery and aspiration combined with methylprednisolone acetate injection plus wrist immobilization in the treatment of dorsal carpal ganglion. , 2004, Journal of the Medical Association of Thailand = Chotmaihet thangphaet.

[19]  R. Berger,et al.  Arthroscopic resection in the management of dorsal wrist ganglions: results with a minimum 2-year follow-up period. , 2004, The Journal of hand surgery.

[20]  F. Burke,et al.  Primary care referral protocol for wrist ganglia , 2003, Postgraduate medical journal.

[21]  J. Dias,et al.  Palmar Wrist Ganglion: Does Intervention Improve Outcome A Prospective Study of the Natural History and Patient-Reported Treatment Outcomes , 2003, Journal of hand surgery.

[22]  A. Aydın,et al.  [Surgical treatment of volar wrist ganglia]. , 2003, Acta orthopaedica et traumatologica turcica.

[23]  J. Taras,et al.  GANGLION CYSTS OF THE WRIST , 2002 .

[24]  T. Davis,et al.  Ganglia: The Patient’s Perception , 2000, Journal of hand surgery.

[25]  L. Thornburg.  Ganglions of the hand and wrist. , 1999, The Journal of the American Academy of Orthopaedic Surgeons.

[26]  A. Osterman,et al.  Arthroscopic resection of dorsal ganglion of the wrist. , 1995, Hand clinics.

[27]  K. Govaers,et al.  The Volar Wrist Ganglion: Just a Simple Cyst? , 1990, Journal of hand surgery.

[28]  G. Lister,et al.  Protection of the radial artery in the resection of adherent ganglions of the wrist. , 1978, Plastic and reconstructive surgery.