THE SURGICAL TREATMENT OF MUCOUS CYSTS OF THE DISTAL INTERPHALANGEAL JOINTS OF THE FINGERS: REVIEW OF CASES AND EVALUATION OF OUTCOME

Abstract

PURPOSE: The success of treatment for mucous cysts of the distal interphalangeal joints of the fingers has been widely variable. The aim of this study was to evaluate the results of surgical treatment of these cysts at our hand unit.

METHODS: Eighty one cysts were treated, with a mean follow up of 18 months(6–24 months). Thirty-one patients (25%) had nail ridging or deformity at presentation. All patients had surgical excision and joint debridement through a dorsal approach.

RESULTS: All patients who underwent surgery had evidence of osteoarthritis with osteophytosis at the time of surgery. No recurrences were noted. Nail ridging resolved after surgery in 55 (67%) digits; the remaining digits had partial improvement or persistent ridging. Five (6%) infections occurred and were treated successfully with antibiotics(4 cases) or debridement,(1 case).6 patients had increased stiffness of the joint and occasional pain or swelling noted in 8 (9.8%) cases.

CONCLUSIONS: Contrary to the published literature, the recurrence rate following excision and joint debridement is very low. Although some patients have decreased range of motion, pain is usually relieved. Some residual sypmtoms might be related to the underlying arthritic process rather than a complication of treatment.