Ganglion cysts of the wrist: pathophysiology, clinical picture, and management

Gude, Warren; Morelli, Vincent

doi:10.1007/s12178-008-9033-4

Cited by 190 publications

(244 citation statements)

References 38 publications

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“…Despite the long follow-up period, the recurrence rate in the present series (52.4%) is consistent with other reported recurrence rates of shorter duration (15). Gude and Morelli (15) found an average recurrence rate for aspiration alone of 51% and recurrence with aspiration and corticosteroid injection of 52%.…”

Section: Discussionsupporting

confidence: 91%

Long-term outcomes and patient satisfaction following wrist ganglion aspiration

Head¹,

Allen²,

Boyd³

2015

CAN J PLAST SURG

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Ganglions are the most common benign soft tissue tumours of the hand and wrist (1). The indications for treatment include pain, stiffness, weakness and cosmetic concern. There are many potential treatment modalities but aspiration is the most common. Although there is a large body of evidence addressing short-term outcomes following aspiration, few studies have reported long-term outcomes and even fewer have reported patient satisfaction following treatment. The objective of the present study was to evaluate patient satisfaction and the long-term rate of recurrence following wrist ganglion aspiration. METHODSFollowing Ottawa Health Science Network Research Ethics Board (Ottawa, Ontario) approval, a retrospective study was initiated. Charts of all patients with a single dorsal or volar wrist ganglion treated between 2001 and 2011 were reviewed; patients with multiple ganglions were excluded. A single surgeon treated all patients. When patients desired intervention for their symptomatic ganglion, the surgeon's practice was to treat with aspiration and not surgical excision. Ganglions were aspirated using an 18-gauge needle, and the surgeon facilitated aspiration by massaging the ganglion fluid toward the aspirating needle with a finger. Demographic (date of birth, treatment date, sex) and clinical data (ganglion location, size, treatment, reason for seeking treatment) were retrieved from electronic patient records. Patients were contacted by telephone and asked to complete a questionnaire addressing recurrence, satisfaction and symptomatic improvement (pain, function, range of motion, appearance). Symptomatic improvement was assessed using a Likert scale from 1 to 5, with 1 indicating 'significantly worse' and 5 indicating 'significantly improved'. Statistical analysis was performed using Pearson χ 2 , Mann-Whitney-Wilcoxon and Fisher's exact tests. RESULTSA total of 41 consecutive patients, all treated with aspiration, were identified using hospital records. Of the 41 patients, 21 (51%) consented to the telephone questionnaire, 17 could not be reached due to inadequate hospital records or change in address, one was deceased and two did not consent (Figure 1). Demographic and clinical data from the 41 patients are shown in Table 1. There were no differences in demographic or clinical data between patients who completed the telephone questionnaire and those who did not.Among the 21 patients who completed the telephone questionnaire, the mean (± SE) time to follow-up was 6.3±0.4 years. The rate BACKgROUND: There is a strong body of evidence addressing shortterm outcomes following wrist ganglion aspiration; however, few studies have investigated long-term outcomes and patient satisfaction. OBJECTIVE: To evaluate patient satisfaction and the long-term rate of recurrence following wrist ganglion aspiration. METHODS: Charts of all patients with a wrist ganglion treated by a single surgeon from 2001 to 2011 were reviewed. Demographic and clinical data were retrieved from patient charts. Patients were contacted by telepho...

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Section: Discussionsupporting

confidence: 91%

Long-term outcomes and patient satisfaction following wrist ganglion aspiration

Head¹,

Allen²,

Boyd³

2015

CAN J PLAST SURG

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“…7 Nonsurgical Fig 4. With the patient lying supine and the right wrist suspended, a blunt trochar is introduced to the wrist joint via the 6R portal, identified by the red arrow. Note the dorsal ganglion (black arrow).…”

Section: Discussionmentioning

confidence: 99%

Dry Arthroscopic Excision of Dorsal Wrist Ganglion

Gray

Zuhlke

Eizember

et al. 2017

Arthroscopy Techniques

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Ganglions are common soft tissue masses of the hand. High recurrence rates are associated with nonsurgical treatment; thus, excision is often indicated. Arthroscopic excision and open excision have similar recurrence rates; however, the latter is associated with prolonged healing time and increased scarring. Recently, dry wrist arthroscopic techniques have been used. This technique allows easier confirmation of complete ganglion removal, easier conversion to open surgery, earlier return of motion, and stitch-less closure when compared with traditional "wet" arthroscopic excision. 3 Recently dry wrist arthroscopic techniques have been described. 4,5 This technique may be employed to remove ganglions. Dry wrist arthroscopy has several advantages over standard the "wet" technique due to avoidance of fluid extravasation and associated swelling: (1) easier visualization and palpation of the ganglion during surgical removal allowing for more accurate confirmation of complete removal, (2) easier conversion to open surgery if arthroscopic removal fails, (3) faster rehabilitation and return of motion, and (4) stitchless closure (steri strips are adequate) allowing for reduced scarring and improved cosmesis.We present our technique for dry arthroscopic wrist ganglionectomy.

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“…For those that do not, patients are often offered an attempt at aspiration, which is currently the mainstay of nonsurgical treatment [11]. However, aspiration has shown limited efficacy with a recurrence rate of 53% (Table 3) [6,12,19,22,24,29].…”

Section: Discussionmentioning

confidence: 99%

Blunt Force May be an Effective Treatment for Ganglion Cysts

Trivedi¹,

Schreiber²,

Daluiski

2016

HSS Jrnl

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Background: Ganglion cysts are the most common soft tissue tumors of the hand and wrist. There is currently no data available for the recurrence or complication rate of patients that self treat ganglion cysts by using an extrinsic force. Despite this absence of evidence, patients are still using this mode of treatment. Questions/Purposes: The purpose of the study is to evaluate the efficacy of blunt force as a treatment modality for disrupting ganglion cysts. Methods: We analyzed videos of patients attempting to disrupt their ganglion cysts of the wrist by blunt force on Youtube.com and surveyed them anonymously. Candidates were contacted through YouTube's email server and given a link to an online questionnaire. Results: Two hundred fourteen individuals were reviewed with a total of 1,008,913 views. Eighty three percent of videos were effective in treating the cyst. All 38 individuals that responded to the survey reported that the blunt force was effective in immediate elimination of the cyst in an average of 1.6 attempts (range 1-5). A majority (N = 21, 55%) reported no recurrence since the initial disruption of the cyst at a follow-up of 24 months. Conclusions: YouTube.com was found to be an effective outlet to study a treatment modality that would otherwise be limited by practical considerations. The study showed that a subset of patients is utilizing blunt force trauma to successfully treat wrist ganglion cysts.

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Ganglion cysts of the wrist: pathophysiology, clinical picture, and management

Cited by 190 publications

References 38 publications

Long-term outcomes and patient satisfaction following wrist ganglion aspiration

Long-term outcomes and patient satisfaction following wrist ganglion aspiration

Dry Arthroscopic Excision of Dorsal Wrist Ganglion

Blunt Force May be an Effective Treatment for Ganglion Cysts

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