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WRIST GANGLIONS


WHAT YOU SHOULD KNOW

Ganglion cysts are small masses that appear and may grow to varying sizes. The most common type appears on the back side of the wrist. The second most common type appears on the front side of the wrist. Sometimes they get larger and smaller because they are sacs filled with a jelly-like material. The sacs protrude from the wrist joint due to friction from nearby tendons. They are not tumors and cannot do harm to the patient other than producing local symptoms.

MEDICAL HISTORY

Patients often note the changing size of the masses. Some complain of stiffness, a mild aching pain, or weakness. Most are mainly bothered by seeing the abnormal growth in the body.

EXAMINATION

The size, consistency, mobility, and location of the mass are noted along with any deficits in function of nearby joints or tendons.

ADDITIONAL TESTS: None are needed in advance. The specimen obtained at the time of surgery is sent to the lab for analysis to prove it was a ganglion and not a tumor.

TREATMENT OPTIONS

 NON-OPERATIVESURGICAL ELIMINATION BY ARTHROSCOPYSURGICAL ELIMINATION BY INCISION
CONSISTS OFObservation or aspirationElimination from within the jointOpen incision through the skin over the mass
FEATURESSticking a large needle into the mass in the office may deflate its sizeOutpatient surgery, fiber optic camera into joint to eliminate the origin of the cyst at the joint levelOutpatient surgery, full size incision
ADVANTAGESAvoids surgeryOnly cut on the body is 2 tiny poke holesEnsures getting the entire lesion including the cyst wall
DISADVANTAGESRecurrence rate is over 80%Large and longstanding cysts leave the wall of the sac behindLeaves a scar proportionate to the size of the mass, increased stiffness

RECOVERY

Sutures are removed in the office at 2 weeks. No splints are used. Rehabilitation exercises to restore full motion and then strength are begun immediately after surgery. Recovery of wrist and hand function is faster following arthroscopy than after open incision. Most patients are able to use their hands and wrists for normal activities within a month of surgery.
 
 
 
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