Arthroscopic resection of dorsal wrist ganglia and treatment of recurrences

Primary care referral protocol for wrist ganglia

The paper summarises current knowledge on ganglia of the wrist including the views of patients and doctors. The efficacy of available treatment options are discussed. Summary points are derived from the available knowledge with a referral protocol from primary care.

Arthroscopic resection of volar ganglion of the wrist: A new technique

We evaluated a new arthroscopic technique for treating volar ganglion of the wrist. Arthroscopic resection of volar wrist ganglion was performed under local anesthesia to the portal sites. Arthroscopic instruments were introduced dorsally, and the intra-articular lesion at the interval between the radioscaphocapitate (RSC) and long radiolunate (LRL) ligaments was debrided under direct view. Mucinous content of the ganglion was evacuated using suction, but the ganglion sac was not removed. The technique was successful in 5 cases between August 1997 and November 1998, with an average surgery time of 55 minutes. No complications or recurrence occurred at a mean follow-up of 16.4 months. This is the first report of arthroscopic decompression of volar wrist ganglions and provides new insight into the etiology of these lesions.

Dorsal ganglion of the wrist: results of treatment by arthroscopic resection

Between September 1997 and September 2000, 32 patients (20 males and 12 females; average age 23.7 years) received arthroscopic surgery for dorsal wrist ganglion. Five of the patients (15.6%) experienced recurrences after open surgery. All patients complained of pain or a cosmetic problem due to the lump. Before the operation, they were all sonographically examined using a high-resolution 7.5 MHz real-time probe. After operation, they were followed-up by telephone after 15 to 37 months (mean 26.8 months). No recurrences occurred in our series. Arthroscopic resection is safe and addresses the anatomic pathology. Recurrences have been fewer than in the reported results of the open surgery. The approach is reasonable for operatively treating the dorsal ganglion.

Arthroscopic diagnosis and treatment of dorsal wrist ganglion

Thirty-seven patients with dorsal wrist ganglia underwent arthroscopic resection. The mean follow-up was 20 months, and no complications were encountered. The ganglia were classified into three types according to their arthroscopic appearance. This classification helps to determine the amount of dorsal capsular resection required.

Current treatment of ganglion of the wrist

Ganglion of the wrist is one of the the most common lesions of the hand. The cause of pain in an occult dorsal wrist ganglion has been linked to compression of the posterior interosseous nerve at the wrist. A case is presented in this paper and the pathoanatomy discussed. Ultrasound-guided aspiration after hyaluronidase instillation provided a useful alternative to surgery with a high success rate. Arthroscopic decompression for dorsal and palmar wrist ganglia offered the patient the benefit of smaller surgical scars and a high success rate. A description of the surgical techniques, pathoanatomy, and early results of the authors and a review of the literature is presented.