WHAT YOU SHOULD KNOW
Ganglion cysts are small masses that appear and may grow to varying sizes. The most common type appears on the back side of the wrist. The second most common type appears on the front side of the wrist. Sometimes they get larger and smaller because they are sacs filled with a jelly-like material. The sacs protrude from the wrist joint due to friction from nearby tendons. They are not tumors and cannot do harm to the patient other than producing local symptoms.
MEDICAL HISTORY
Patients often note the changing size of the masses. Some complain of stiffness, a mild aching pain, or weakness. Most are mainly bothered by seeing the abnormal growth in the body.
EXAMINATION
The size, consistency, mobility, and location of the mass are noted along with any deficits in function of nearby joints or tendons.
ADDITIONAL TESTS: None are needed in advance. The specimen obtained at the time of surgery is sent to the lab for analysis to prove it was a ganglion and not a tumor.
TREATMENT OPTIONS
| NON-OPERATIVE | SURGICAL ELIMINATION BY ARTHROSCOPY | SURGICAL ELIMINATION BY INCISION | |
| CONSISTS OF | Observation or aspiration | Elimination from within the joint | Open incision through the skin over the mass |
| FEATURES | Sticking a large needle into the mass in the office may deflate its size | Outpatient surgery, fiber optic camera into joint to eliminate the origin of the cyst at the joint level | Outpatient surgery, full size incision |
| ADVANTAGES | Avoids surgery | Only cut on the body is 2 tiny poke holes | Ensures getting the entire lesion including the cyst wall |
| DISADVANTAGES | Recurrence rate is over 80% | Large and longstanding cysts leave the wall of the sac behind | Leaves a scar proportionate to the size of the mass, increased stiffness |
RECOVERY
Sutures are removed in the office at 2 weeks. No splints are used. Rehabilitation exercises to restore full motion and then strength are begun immediately after surgery. Recovery of wrist and hand function is faster following arthroscopy than after open incision. Most patients are able to use their hands and wrists for normal activities within a month of surgery.
