DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20162871

Arthroscopic resection of dorsal wrist ganglion

Mihir R Patel, Ushma K Butala, Vikram D Chauhan, Nirlepsinh S Thakor

Abstract


Background: The management of dorsal wrist ganglion ranges from benign neglect to surgical excision. The purpose of this study was to study the results of arthroscopic resection of dorsal wrist ganglion.

Methods: Twenty one patients who had undergone arthroscopic dorsal wrist ganglion excision and a minimum of 3 months follow up were included. The preoperative complaint of cosmesis, pain, and duration of swelling, wrist range of motion and size of the ganglion were noted. The duration the patient took to return to a painless wrist with full range of motion was noted. Patient satisfaction with respect to cosmesis and function was noted.

Results: The mean age was 23.3 years (range: 13 to 35 years). Pre-operative wrist pain was present in 17 patients and cosmesis was a complaint in 18 patients. 5 patients had a pre-operative restricted range of motion. The mean duration and size of the ganglion was 2.6 months (range: 2 to 4 months) and1.8cm (range: 1 to 3 cm) respectively. The mean duration of follow up was 14.6 months (range: 3 to 24 months). Arthroscopically, dorsal synovitis was present in 10 patients, triangular-fibro-cartilage-complex (TFCC) tear in 2 patients and chondral damage in 1 patient. The ganglion stalk was visualized in 14 patients. Complete painless wrist range of motion was obtained by 20 patients by 3 weeks post-operative.  One patient had a recurrence. All the remaining patients were satisfied cosmetically and functionally with the results.

Conclusions: Arthroscopic resection is an effective treatment modality for symptomatic dorsal wrist ganglion with good functional and cosmetic results.

Keywords


Arthroscopy, Dorsal wrist ganglion, Resection

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References


Athanasian EA. Bone and soft tissue tumors. In: Green DP, Hotchkiss R, Pederson C, Wolfe S, eds. Green’s operative hand surgery. 5th ed. New York: Churchill Livingstone. 2005:2211-64.

Angelides AC, Wallace PF. The dorsal ganglion of the wrist: its pathogenesis, gross anatomy and surgical treatment. J Hand Surg. 1976;1:228-35.

Clay NR, Clement DA. The treatment of dorsal wrist ganglia by radial excision. J Hand Surg. 1988;13B:187-91.

Carp L, Stout AP. A study of ganglion with special reference to treatment. Surg Gynecol Obstet. 1938;47:460-8.

Watson HK, Rogers WD, Ashmead DF. Re-evaluating the cause of the wrist ganglion. J Hand Surg. 1989;14A:812-7.

Nelson CL, Sawmiller S, Phalen GS. Ganglions of the wrist and hand. J Bone Joint Surg. 1972;5A:1459-64.

McEvedy BV. Simple ganglia: a review of modes of treatment and an explanation for the frequent failures of surgery. Lancet. 1965;266:135.

Richman JA, Gelberman RH, Engher WD, Salamon PB, Bean DJ. Ganglions of the wrist and digits: results of treatment by aspiration and cyst wall puncture. J Hand Surg. 1987;12A:1041-3.

Zubowicz VN, Ischii CH. Management of ganglion cysts of the hand by simple aspiration. J Hand Surg. 1987;12A:618-20.

Crawford GP, Taleisnik J. Rotary subluxation of the scaphoid after excision of dorsal carpal ganglion and wrist manipulation: a case report. J Hand Surg. 1983;8A:921-5.

Osterman AL, Raphael J. Arthroscopic resection of dorsal ganglion of the wrist, Hand Clinics. 1995;11:7-12.

Pederzini L, Ghinelli, Soragni O. Arthroscopic treatment of dorsal arthrogenic cysts of the wrist. Journal of Sports Traumatology and Related Research. 1995;17:210-5.

Fontes D. Ganglia treated by arthroscopy. In: Saffer P, Amaido PC, Foucher G, eds. Current practice in hand surgery. London, Martin Dunitz. 1997:283-90.

Luchetti R, Badia A, Alfarano M, Orbay J, Indriago I, Mustapha B. Arthroscopic resection of dorsal wrist ganglia and treatment of recurrences. J Hand Surg. 2000; 25B:38-40.

Gallego S, Mathoulin C. Arthroscopic resection of dorsal wrist ganglia: 114 cases with minimum follow-up of 2 years. Arthroscopy. 2010;26:1675-82.