Does ganglionectomy destabilize the wrist over the long-term?

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Musculoskeletal Disorders

Background:

• Previous studies noted persistent symptoms after ganglion removal.
• Scapholunate instability was reported in a small subset of patients post-ganglionectomy.
• This study specifically investigated wrist instability following ganglionectomy.

Purpose of the Study:

• To evaluate wrist instability, particularly scapholunate joint stability, after wrist ganglionectomy.
• To assess long-term patient outcomes, including symptoms, range of motion, grip strength, and patient satisfaction.
• To determine the incidence of ganglion recurrence and other postoperative complications.

Main Methods:

• A retrospective review of 91 consecutive wrist ganglionectomy cases (1987-1993).
• Standardized telephone interviews with 71% of patients at an average of 44 months post-operation.
• Assessment of range of motion, grip strength, scaphoid mobility, and radiographic analysis for scapholunate relationships.

Main Results:

• Twenty-five percent of interviewed patients reported wrist symptoms; however, 95% of these had normal motion and no carpal instability.
• No late ganglion recurrence was observed.
• Grip strength averaged 12% below normal in 45% of dominant hands; radiographs showed no scapholunate dissociation or dynamic instability.

Conclusions:

• Wrist ganglionectomy does not destabilize the wrist, especially the scapholunate joint.
• Meticulous ganglion extirpation is crucial for successful outcomes.
• Hand surgeons should be aware of potential, treatable minor sequelae and consider late patient follow-up.