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OUTCOME OF MANAGEMENT OF PEDAL GANGLIA



Abstract

Between 1st March 1995 and 31st December 2002 we treated 69 patients for pedal ganglia. Review was carried out through a research clinic or by questionnaire by an independent reviewer. One patient had died of unrelated causes and one was housebound and deaf. Fourteen were lost to follow-up; final results are pending in 15.

Of the patients reviewed, 13 were treated by observation. Six were male, seven female, aged 16–76, median follow-up 59 months (range 40–106). Eight had no pain and five had occasional pain. None had interference with activities of daily living (ADL). Four chose shoes for comfort and nine could wear any. All had residual ganglia 3–5 mm in diameter but only five were bothered by them. One patient had undergone excision of the ganglion.

Twenty-one had aspiration and injection of ganglia. Eleven were male and ten female, aged 33–80, median follow-up 58 months (range 20–92). Ten had no pain and 11 occasional pain. Sixteen had no problems with ADL, four had interference with recreational activities and one interference with all ADL. Fourteen could wear any shoe and seven chose shoes for comfort. Eighteen were not bothered by their ganglion, two were occasionally bothered and one bothered often. Ten had no treatment other than aspiration and injection, four had repeat aspiration (one twice) and nine had the ganglion excised (two repeat excisions). Five had residual ganglia (three after surgery), two had tender scars and two altered sensation.

Four patients had primary excision. None had any pain, problems with ADL or shoe wear restrictions; one was occasionally bothered by the ganglion site. There were no recurrent ganglia but two had uncomfortable scars.

Many ganglia can be managed by simple treatment and surgery is often followed by minor residual symptoms.

Correspondence should be addressed to BOFSS, c/o Wrightington Wigan and Leigh NHS Trust, Hall Lane, Appley Bridge, Wigan, Lancashire WN7 9EP.