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The volar wrist ganglion: just a simple cyst?
1Department of Orthopaedic and Accident Surgery, University Hospital, Nottingham.
Abstract:
The results of operation on 71 volar wrist ganglia are reported. The recurrence rate was 28%, occurring between 1 and 144 months (median: 5 months). The highest risk of recurrence is in a male patient, under 30 years of age, in a manual occupation, operated on by a junior surgeon. The use of a post-operative plaster slab seemed to be followed by significant wrist stiffness. 28% of the patients had evidence of damage to the palmar cutaneous branch of the median nerve. It is suggested that this could be avoided by positive identification of this nerve at operation.
Insights
This study on wrist ganglia surgery found a 28% recurrence rate, with higher risks for younger males in manual jobs. Post-operative stiffness and median nerve damage were also noted.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Musculoskeletal Disorders
Background:
- Volar wrist ganglia are common benign tumors.
- Surgical excision is a primary treatment modality.
- Recurrence and complications can impact patient outcomes.
Purpose of the Study:
- To report outcomes of surgical excision for volar wrist ganglia.
- To identify risk factors for recurrence.
- To assess the incidence of post-operative complications.
Main Methods:
- Retrospective analysis of 71 patients undergoing surgery for volar wrist ganglia.
- Data collection on recurrence, complications, and patient demographics.
- Statistical analysis to identify risk factors for recurrence.
Main Results:
- A 28% recurrence rate was observed, with a median time to recurrence of 5 months.
- Younger male patients in manual occupations and those operated on by junior surgeons had a higher risk of recurrence.
- Post-operative wrist stiffness was associated with the use of a plaster slab.
- Median nerve palmar cutaneous branch damage occurred in 28% of patients.
Conclusions:
- Surgical outcomes for volar wrist ganglia are reported with significant recurrence rates.
- Risk factors for recurrence include patient demographics and surgeon experience.
- Minimizing post-operative stiffness and preventing median nerve injury are crucial.
- Positive identification of the palmar cutaneous branch of the median nerve during surgery may prevent iatrogenic injury.