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Osteophyte-Sparing Treatment of Mucous Cysts: Case Analysis and Surgical Technique
Taylor Bates1, Julia A V Nuelle, James K Aden
1From the Department of Orthopaedic Surgery, San Antonio Military Medical Center, Fort Sam Houston, TX (Dr. Bates, Dr. Nuelle, and Dr. Lynch); San Antonio Military Medical Center, San Antonio Uniformed Services Health Education Consortium, Fort Sam Houston, TX (Dr. Aden); Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD (Dr. Wind); and Manus Center PA, Vienna, VA (Dr. Shepler).
Objective:
The purpose of this study was to examine patient outcomes and the risk of recurrence of mucous cysts affecting the distal interphalangeal (DIP) joint in the absence of osteophytectomy using the described flap technique.
Methods:
A retrospective review of 143 records of patients who were treated for mucous cysts of the DIP joint by a single surgeon. Inclusion criteria included the absence of an osteophytectomy during treatment using the described dorsally based flap technique and a minimum of 12 months of follow-up.
Results:
A total of 143 mucous cysts affecting the DIP joint of 131 patients with an average age of 65.3 years were included. The average follow-up was 21.9 months (12 to 139). Postoperative DIP joint extension was less in the surgical digit compared with the same digit of the contralateral hand with a significant change from the preoperative motion (1.5° versus 0.3°; P = 0.05). No significant change in the postoperative flexion of the DIP joint was observed compared with that of the contralateral side (-1.4° versus -0.9°; P = 0.57). Recurrence occurred in 2 patients (1.4%). No infections or wound complications were identified.
Conclusions:
Using the described technique without an osteophytectomy seemed to be an effective treatment of mucous cysts originating from the DIP joint.
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