Abstract
AIM: The aim of this study is to assess the efficacy of different treatment options for wrist ganglia.
METHODS AND RESULTS: 1700 cases were reviewed retrospectively. Of the respondents to the questionnaire, 457 (65%) patients had dorsal, 255 patients (35%) volar wrist ganglia.
Dorsal ganglia had been treated by observation in 99 (22.4%), aspiration in 57 (12.9%), aspiration plus injection in 37 (8.4%) or surgery in 249 (56.3%) of the cases. The analysis showed that the recurrence rates were 39%, 74.5%, 28.5%, and 35% respectively for each type of treatment. Scar tenderness was present in more than half of surgically treated patients. Repeat surgery was performed in 20 out of 70 (28.5%) recurrent cases. The satisfaction rate did not correlate with the recurrence rate.
For volar ganglia, treatment had been observation in 49 (19.2%), aspiration in 13 (5%), aspiration plus injection in 12 (4.7%) or surgery in 153 (60%) of the cases. The analysis showed that the recurrence rates were 28.5%, 92%, 25.5%, and 33.3% respectively. Scar tenderness was present in 67% and sensory loss in 32% of surgically treated patients. Repeat surgery was only performed in 18 out of 52 (34.6%) recurrences. The satisfaction rate was highest in the aspiration and injection group, which had the lowest recurrence rate among all treatment modalities.
CONCLUSION: The treatment of wrist ganglia needs a rethink in the light of the current findings as the complications may be difficult to justify in such a self-limiting condition.
Correspondence should be addressed to Mr Bimal Singh, BOSA at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE
