eMedicine Specialties > Orthopedic Surgery > Hand & Upper Extremity

Ganglions: Follow-up

Author: Anthony Schena, MD, Consulting Surgeon, ProSports Orthopedics; Associate Professor, Department of Orthopedics, Tufts Medical School
Coauthor(s): Robert Q Terrill, MD, Assistant Professor, Department of Orthopedic Surgery, University of Massachusetts Medical Center
Contributor Information and Disclosures

Updated: Apr 10, 2008

Outcome and Prognosis

Given that ganglions are benign lesions, the overall prognosis is excellent with open surgical treatment. Recurrence rates of 10-15% are typically reported. Excision of the cyst with a small ring of capsule has been shown to reduce the recurrence to 4% when compared with resection of the cyst alone (13-40%).

Osterman and Raphael found that arthroscopic treatment was also safe and reliable.10 They had recurrences equal to those reported with open procedures. Arthroscopic resection also resulted in smaller surgical scars.

Sanders reported dramatic improvement of function and relief of pain in selected patients who had a suspected occult ganglion.11

Future and Controversies

Currently, the only controversial treatment for dorsal wrist ganglions is arthroscopy. Many articles support the use of the arthroscopy for ganglion excisions.

 


More on Ganglions

Overview: Ganglions
Workup: Ganglions
Treatment: Ganglions
Follow-up: Ganglions
References

References

  1. Hooper G. Cystic swellings. In: Bogumill GB, Fleegler EJ, eds. Tumors of the Hand and Upper Limb. Churchill Livingstone;1993:172-82.

  2. Thornburg LE. Ganglions of the hand and wrist. J Am Acad Orthop Surg. Jul-Aug 1999;7(4):231-8. [Medline].

  3. Angelides AC. Ganglions of the hand and wrist. In: Green DP, Hotchkiss RN, eds. Operative Hand Surgery. 3rd ed. Churchill Livingstone;1993:2157-71.

  4. Oztürk K, Esenyel CZ, Demir BB, Sönmez MM, Kara AN. [Occult scapholunate ganglion in patients with dorsoradial wrist pain]. Acta Orthop Traumatol Turc. Nov-Dec 2007;41(5):349-54. [Medline].

  5. Darcy PF, Sorelli PG, Qureshi F, Orakwe S, Ogufere W. Carpal tunnel syndrome caused by an intraosseous ganglion of the capitate. Scand J Plast Reconstr Surg Hand Surg. 2004;38(6):379-81. [Medline].

  6. Arabori M, Kitazawa H, Akisue T, Kuroda R, Fujioka H, Doita M, et al. Intraosseous ganglion of the phalanx. Clin Imaging. Jan-Feb 2008;32(1):73-6. [Medline].

  7. Cheng JW, Tang SF, Yu TY, Chou SW, Wong AM, Tsai WC. Sonographic features of soft tissue tumors in the hand and forearm. Chang Gung Med J. Nov-Dec 2007;30(6):547-54. [Medline].

  8. Wang G, Jacobson JA, Feng FY, Girish G, Caoili EM, Brandon C. Sonography of wrist ganglion cysts: variable and noncystic appearances. J Ultrasound Med. Oct 2007;26(10):1323-8; quiz 1330-1. [Medline].

  9. Kayalar M, Vatansever A, Bal E, Toros T, Ozaksar K, Ada S. [The importance of finger extension test in the diagnosis of occult wrist ganglion]. Acta Orthop Traumatol Turc. 2007;41(1):42-7. [Medline].

  10. Osterman AL, Raphael J. Arthroscopic resection of dorsal ganglion of the wrist. Hand Clin. Feb 1995;11(1):7-12. [Medline].

  11. Sanders WE. The occult dorsal carpal ganglion. J Hand Surg [Br]. Jun 1985;10(2):257-60. [Medline].

  12. Dias JJ, Dhukaram V, Kumar P. The natural history of untreated dorsal wrist ganglia and patient reported outcome 6 years after intervention. J Hand Surg Eur Vol. Oct 2007;32(5):502-8. [Medline].

Further Reading

Keywords

hand tumors, wrist tumors, dorsal wrist ganglions, ganglion cyst, occult dorsal ganglions, volar wrist ganglions, intraosseous ganglion cysts

Contributor Information and Disclosures

Author

Anthony Schena, MD, Consulting Surgeon, ProSports Orthopedics; Associate Professor, Department of Orthopedics, Tufts Medical School
Anthony Schena, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons and Arthroscopy Association of North America
Disclosure: genzyme Honoraria Speaking and teaching

Coauthor(s)

Robert Q Terrill, MD, Assistant Professor, Department of Orthopedic Surgery, University of Massachusetts Medical Center
Robert Q Terrill, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Orthopaedic Surgeons, American Society for Surgery of the Hand, and Massachusetts Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Peter M Murray, MD, Associate Professor of Orthopedic Surgery, Mayo Clinic College of Medicine; Director of Education, Mayo Foundation for Medical Education and Research, Jacksonville; Consultant, Department of Orthopedic Surgery, Mayo Clinic, Jacksonville; Consulting Staff, Nemours Children's Clinic and Wolfson's Children's Hospital
Peter M Murray, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association for Hand Surgery, American Orthopaedic Association, American Society for Reconstructive Microsurgery, American Society for Surgery of the Hand, Florida Medical Association, Orthopaedic Research Society, and Society of Military Orthopaedic Surgeons
Disclosure: Small Bone Innovations Workshop Honoraria Speaking and teaching

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Thomas R Hunt III, MD, John D Sherrill Professor and Director of Orthopaedic Surgery, Surgeon in Chief of UAB Highlands Hospital, Director of Hand and Upper Extremity Fellowship, University of Alabama at Birmingham
Thomas R Hunt III, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association for Hand Surgery, American Orthopaedic Association, American Orthopaedic Society for Sports Medicine, American Society for Surgery of the Hand, AO Foundation, Mid-America Orthopaedic Association, and Southern Orthopaedic Association
Disclosure: Tornier Consulting fee Review panel membership; Tornier Royalty None; Tornier Ownership interest None

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Harris Gellman, MD, Consulting Surgeon, Broward Hand Center; Voluntary Clinical Professor of Orthopedic Surgery and Plastic Surgery, Departments of Orthopedic Surgery and Surgery, University of Miami School of Medicine
Harris Gellman, MD is a member of the following medical societies: American Academy of Medical Acupuncture, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Society for Surgery of the Hand, and Arkansas Medical Society
Disclosure: Nothing to disclose.

 
 
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