Ganglion Recurrence Rates After a Simple Puncture and a Review of the Literature

Aim Ganglia are the most common masses of the hand. While benign, they can be symptomatic. Nonsurgical treatment includes observation, manual rupture, puncture, or aspiration. There is a broad range of recurrence rates cited in the literature with aspiration and puncture. The purpose of this study is to determine recurrence rates and patient satisfaction after a simple puncture of the hand and wrist ganglia. Materials and methods We retrospectively identified a cohort of consecutive new patients arriving at the senior author's (RS) office from 2020 to 2022 who underwent simple puncture of a ganglion. Patients were examined by the senior author and the diagnosis of a ganglion was confirmed upon simple puncture with expression of mucinous fluid. A chart review was performed to collect basic demographic data, location of ganglion, and duration of symptoms. Patients were then contacted via telephone and their satisfaction and the rate of recurrence was determined. Results There were 64 patients identified as having undergone puncture of their ganglia. There were 34 patients able to be reached via telephone and 56% of the ganglia recurred with an average time to recurrence of 43 weeks. Of the 34 patients that participated, 79% (27/34) reported that they would choose simple puncture again if they had another ganglion and 76% (26/34) reflected favorably on the puncture procedure. Of the 19 patients with recurrence, eight patients underwent an additional procedure: four underwent surgery and four underwent repeat puncture, with a 75% recurrence rate in the repeat puncture group. Conclusions Our series demonstrates a recurrence rate of 56% for hand and wrist ganglia after simple needle puncture with no complications and high patient satisfaction. The literature has conflicting evidence regarding the optimal treatment of hand and wrist ganglia, however, a simple needle puncture is a reasonable first step in treating ganglia and can immediately confirm the diagnosis of a ganglion.