What is it?
Ganglions are fluid filled cysts that arise from a joint or tendon. A small perforation in a ligament or tendon sheath can create a one way valve where fluid can feed the cyst but not let fluid back out. This can cause a local swelling of a few mm or a 1-2 cm or more depending on the location. Ganglions can be painless or can cause pain and discomfort from pressure and irritation of the surrounding tissues. Ganglions are very common and often found on the back of the wrist, palm of the hand or near the nail, at the DIPJ, but can arise in other parts of the hand and wrist. When they are not causing problems they can be left untreated without risk of long term damage or deterioration and can fluctuate in size or resolve spontaneously.
What can be done to treat ganglion cysts?
Options for treatment include needle aspiration of the fluid +/- cortisone injection in larger ganglions in the wrist, arthroscopic or open excision.
What are the risks of the ganglion reforming?
Research data has been combined to show overall recurrence rates for the different treatment options for wrist ganglia, which are the most common:
- Aspiration 59%
- Open excision 21%
- Arthroscopic excision 6%
What are the complications of surgery?
Complications vary and depend on the location of the ganglion and the surrounding soft tissue structures. These can include the nerves that supply the sensation to the skin, arteries and skin wound infection or breakdown. Complications can include infection, neuroma and nerve sensitivity, hypertrophic scar and artery damage.
Complication rates for treatment of wrist ganglions (volar and dorsal):
- Aspiration 3%
- Open excision 14%
- Arthroscopic excision 4%