Dorsal and volar wrist ganglions: The results of surgical treatment

Sebastian Kuliński, Olga Gutkowska, Sylwia Mizia, Jacek Martynkiewicz, Jerzy Gosk
Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University 2019, 28 (1): 95-102

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.

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