Endoscopic Ganglionectomy and Release of the Sixth Extensor Compartment

Tenoscopy for the Treatment of Hand Intratendinous Ganglion: Technique Description and Case Report

Synovial or ganglion cysts are the most common soft tissue tumors of the wrist and hand and can arise from joints or tendons. Intratendinous synovial cysts, in contrast, are rare and their pathogenesis is still a matter of debate. The treatment of synovial cysts of articular origin using arthroscopy is commonly used with good results. For cysts of tendon origin, that is, extra-articular, when located at the ankle, shoulder, knee, and wrist, endoscopic treatment has also been described in a procedure called tenoscopy. We describe the technique and the good results using tenoscopy for a patient treated for an intratendinous synovial cyst located at the extensor communis tendon of the third digit. It is a reproducible, safe technique with low morbidity, and the patient has had no complications or recurrence.

Endoscopic Release of the Guyon Canal and Pisohamate Hiatus

The ulnar nerve runs in more than 1 tunnel in the wrist. Ulnar nerve entrapment in the wrist can occur at the Guyon canal and the pisohamate hiatus. Open release of these 2 tunnels requires a lengthy incision and extensive soft-tissue dissection. The purpose of this technical note was to describe the details of endoscopic release of the Guyon canal and the pisohamate hiatus. This minimally invasive approach allows release of the ulnar nerve and its motor branch at the wrist level.