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[Occult scapholunate ganglion in patients with dorsoradial wrist pain]

Kahraman Oztürk, Cem Zeki Esenyel, Bilal B Demir, M Mesut Sönmez, Ayhan Nedim Kara
Acta Orthopaedica et Traumatologica Turcica 2007, 41 (5): 349-54

OBJECTIVES: The aim of this study was to assess the results of surgical treatment of patients who had complaints of chronic wrist pain and were diagnosed as having an occult dorsal scapholunate interosseous ganglion, despite the presence of a normal x-ray and absence of trauma.

METHODS: Thirteen wrists of 12 patients (2 males, 10 females; mean age 28 years; range 21 to 41 years) were treated with surgical excision for ganglia originating from the dorsal scapholunate interosseous ligament. Involvement was on the right side in six patients, and on the left in five patients, with one patient having bilateral involvement. None of the patients had a history of trauma, except two with a history of fall. All the patients had complaints of wrist pain that occurred during work and subsided at rest. The mean duration of wrist pain was 23 months (range 6 to 60 months). All the patients received conservative treatment previously with wrist splints and non-steroidal anti-inflammatory drugs. Finger extension test was positive and magnetic resonance imaging of the wrist showed ganglion in all the patients. Functional results were evaluated by the Mayo Clinic wrist pain assessment scores after a mean follow-up of 35 months (range 25 to 49 months).

RESULTS: Complaints of wrist pain improved dramatically in all the patients. Scores of the Mayo Clinic wrist pain assessment were excellent in seven patients (53.9%), good in five patients (38.5%), and moderate in one patient (7.7%). All the patients returned to work without any limitation of wrist movements. No recurrences were seen during the follow-up period.

CONCLUSION: Occult ganglia originating from the scapholunate ligament should be remembered in patients with dorsal scapholunate joint tenderness and pain unresponsive to conservative treatment and with a positive finger extension test.

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