The natural history of untreated dorsal wrist ganglia and patient reported outcome 6 years after intervention

• Published in: The Journal of hand surgery, European volume Vol. 32; no. 5; pp. 502 - 508
• Main Authors: Dias, J.J., Dhukaram, V., Kumar, P.
• Format: Journal Article
• Language: English
• Published: Thousand Oaks, CA Elsevier Ltd 01-10-2007; SAGE Publications; Elsevier
• Subjects: Absenteeism; Adult; aspiration; Biological and medical sciences; Disability Evaluation; Esthetics; Female; Follow-Up Studies; Ganglion Cysts - surgery; Hand Strength; Humans; Male; Medical sciences; natural history; Orthopedic surgery; outcome; Pain Measurement; Patient Satisfaction; Prospective Studies; Recurrence; Suction; surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Wrist - surgery; wrist ganglia; recurrence; wrist ganglia; natural history; outcome; aspiration; surgery; Human; Postoperative; Relapse; Prognosis; Prevalence; Aspiration; Epidemiology; Case history; Symptomatology; Pain; Treatment; Surgery; Upper limb; Wrist ganglia
• ISSN: 1753-1934; 2043-6289
• DOI: 10.1016/j.jhse.2007.05.007

We have evaluated the long-term outcome of excision, aspiration and no treatment of dorsal wrist ganglia prospectively in 236 (83%) of 283 patients who responded to a postal questionnaire at a mean of 70 months. The resolution of symptoms was similar between the treatment groups (
p>0.3). Pain and unsightliness improved in all three treatment groups. The prevalence of weakness and stiffness altered only slightly in all three treatment groups. More patients with a recurrent, or persistent ganglion complained of pain, stiffness and unsightliness (
p<0.0001). Patient satisfaction was higher after surgical excision (
p<0.0001), even if the ganglion recurred. Twenty-three of 55 (58%) untreated ganglia resolved spontaneously. The recurrence rate was 58% (45/78) and 39% (40/103) following aspiration and excision, respectively. Eight out of 103 patients had complications following surgery. In this study, neither excision nor aspiration provided significant long-term benefit over no treatment.