Arthroscopic resection of dorsal wrist ganglia: 114 cases with minimum follow-up of 2 years

Abstract

Purpose: The objective of this study was to review the results of arthroscopic resection of dorsal wrist ganglion (DWG), as well as to describe the senior author's technique and technical details to minimize potential complications.

Methods: Between September 1999 and May 2004, 114 patients underwent arthroscopic resection of DWG with a minimum follow-up of 24 months. We describe the surgical technique and discuss our results and complications.

Results: A total of 114 patients (87 female patients and 27 male patients) with a mean age of 33.1 years were treated with our operative technique. The symptoms at presentation were unsightly appearance in 63 (55.2%), pain in 33 (28.9%), and both unsightly appearance and pain in 18 (15.8%). The patients presented between 1 and 96 months before surgery (mean, 17.81 months). Of the patients, 66 (57.9%) had been treated previously with nonsurgical modalities (aspiration) and 1 had undergone open surgery. The origin of the DWG was more commonly related to the midcarpal joint (85 patients [74.6%]). Our surgery brought about a significant improvement in flexion and extension after surgery (P < .005). Similarly, our surgery brought about a significant improvement in grip strength (P < .005). In patients with preoperative pain, treatment also showed a significant impact. At 2 years' follow-up, there were 14 recurrences (12.3%), diagnosed at a mean of 16.86 months after surgery (range, 2 to 25 months). Complications were identified in 6 patients (5.26%), and the mean time off work was 11 days, with a majority of patients returning in less than 1 week.

Conclusions: Arthroscopic DWG resection showed an improvement in functional measurements in addition to relief of pain in a significant proportion of patients. Complications related to the operative technique did not cause any significant long-term functional deficit. The recurrence rate was 12.3%, and patient satisfaction was high. Arthroscopic technique allows patients to use their hand immediately. The results of this study support the use of arthroscopy as primary treatment for DWG resection.

Level of evidence: Level IV, therapeutic case series.