Pathogenesis, clinic, and treatment of ganglion

In clarification of various theories on the pathogenesis of the ganglion, histopathologic examinations indicate that the ganglion develops from connective tissue by myxoid degeneration and disintegration of collagen fibers. Increasing amounts of mucinous fluid accumulate by the progressive liquefaction of collagen fibers and are surrounded by densifying collagen bundles which form a delimiting capsule. In view of the inadequacy of conservative treatment and the shortcomings of excision, the subcutaneous (s.c.) discission of the ganglion with a tenotome is recommended. Of 184 patients treated this way, 151 displayed full healing, six underwent a successful repetition of the procedure, nine underwent an excision of the recurrent ganglion, and 18 rejected further treatment.