Ganglion cyst associated with triangular fibrocartilage complex tear that caused ulnar nerve compression

Area of Science:

• Orthopedics
• Hand Surgery
• Neurology

Background:

• Ganglion cysts are the most common soft-tissue tumors of the hand.
• Nerve compression secondary to wrist ganglion cysts is infrequent.
• The triangular fibrocartilage complex (TFCC) is a common origin for wrist ganglions.

Observation:

• Two cases of ganglion cysts originating from the TFCC are presented.
• One cyst resulted in significant ulnar nerve compression proximal to Guyon's canal.
• This compression led to the development of ulnar neuropathy.

Findings:

• Ganglion cysts, despite their commonality, can present with rare but serious complications like nerve compression.
• TFCC ganglions are a potential cause of ulnar neuropathy.
• Inadequate hand examination may lead to missed diagnoses of ganglion-related nerve issues.

Implications:

• Highlights the importance of a thorough hand examination in patients with suspected ganglion cysts.
• Emphasizes that even seemingly benign soft-tissue tumors can cause significant neurological deficits.
• Suggests considering TFCC ganglions in the differential diagnosis of ulnar neuropathy at the wrist.