Surgical treatment of volar wrist ganglia

Objectives: We evaluated surgery-related issues concerning the excision of volar wrist ganglia in the light of data obtained from our patients.

Methods: The study included 40 patients (10 males, 30 females; mean age 32.5 years; range 18 to 65 years) who underwent surgery for volar ganglia. All the patients had unilateral involvement. All operations were performed under axillary brachial plexus regional anesthesia in the microsurgery operating room. The mean follow-up period was 2.5 years (range 1 to 5 years).

Results : The ganglia originated from the radioscaphoid joint capsule in 18 patients (45%), scaphotrapezial joint capsule in 16 patients (40%), and from the flexor carpi radialis tendon in two patients (5%). The ganglia were attached to the radial artery in 26 patients (65%), in two patients (5%) the radial artery completely merged into the lesion. The pedicles could not be dissected in four patients (%10), all of whom developed recurrences. Complications included recurrences in nine patients (22%), injury to the median palmar cutaneous nerve in four patients (10%), injury to the radial artery in two patients (5%) and wrist stiffness in five patients (12.5%). No significant correlation was found between complications and experience of the operating surg e o n s .

Conclusion: Considering possible dissections and interventions for complication-associated repairs, and potential recurrences, surgical removal of volar ganglia should be performed under appropriate circumstances, especially in a formal operating room.

Key words: Anesthesia; arteries; median nerve/injuries; radial artery/ surgery; synovial cyst/surgery; wrist/surgery.