GANGLIA (GANGLION, CYSTIC HIGROMA)
They are benign tumors in a cystic nature including gelatinous fluid, oriented from the joint capsule, tendon or tendon sheath. It is the most frequent benign tumor of hand. It is generally observed in women between ages of 20-40. As well as it is observed as a single cyst and oriented from the wrist and certain places in the hand, it may place to anywhere in the hand and the wrist. According to ganglion frequency, it may be in the back of the wrist (dorsal ganglion), in palmar side of the wrist (volar ganglion), in finger side of the palm (volar retinacular ganglion) in palmar side of the wrist (volar ganglion), in finger side of the palm (volar retinacular ganglion)
It does not have certain cause. It may be formed after recurrent little traumas. It is not directly related with the occupation of the patient.○ It may arise immediately or develop slowly. Patients generally apply to the doctor because of the swelling. Swelling may decrease with rest and increase with activity. It may totally disappear after cyst exposure. Over grown cysts may cause pain during joint movements. These cysts are benign, so they do not diffuse.
The disease is diagnosed by detection of the mass in the cyst area during the examination. They may be elliptical or round; soft or very hard. Generally small nodules in the finger bottom are hard. They may be painful when compression comes on or by fisting. Radiological examination is useful to exclude underlying joint mechanic pathologies and bone lesions.
Treatment should be observation in many patients. Some masses are painless. Some of them may disappear in time. When cysts become painful; when limitation arises in movements and functions; when excessive swelling and aesthetically bad view form, surgical treatment should be applied. The surgery is performed under axillary block anesthesia that whole arm is narcotized under non-bleeding conditions. To decrease recurrence possibility to minimum, to reach to the joint space and to remove it by forming a window are required. In some cases, brace using may be required for 10 days after the surgery. Patients return to their normal activities within a short time.