Introduction
Ganglions are fluid filled lumps that can affect any joint but are especially common around the wrist.
Indications
Ganglion cysts that are either unsightly or uncomfortable or affecting hand or wrist function are best treated by surgical excision.
Preoperative Instructions
Ganglion excision is performed as day surgery. It is usually under general anaesthetic or an arm block. You would not normally have to stop any regular medication prior to this minor procedure but Dr Stewart can advise you about your specific requirements.
Procedure
The key to removing a ganglion and avoiding recurrence is to remove not just the ganglion but the origin, which is usually a point on the capsule of the wrist joint. An incision is made over the lump, and the base of the ganglion is dissected to the point of origin, which is excised with a small area of the wrist capsule.
Postoperative Instructions
The wrist is covered with a bulky dressing and after a week this is changed to some surgical tape or Steri Strips and the wrist can then get wet. After 2 weeks no dressings are typically required. The wrist is sometimes a bit tended for 3-4 weeks.
Risks
The main risk of ganglion removal is that the ganglion recurs. Although rare after surgery, there is still around a 5% risk of recurrence.
Treatment Alternatives
An alternative to surgical removal is ultrasound guided aspiration of the ganglion. While this is attractive in terms of avoiding an anaesthetic and a scar, there is a much higher recurrence rate (>50%).