Mucous Cyst
It is a fluid filled cyst, that occurs at the end finger joint (distal inter-phalangeal joint), overlying the bed of the nail. They arise from the joint itself and can cause grooving or splitting of the nail. They may be associated with osteoarthritis of the joint. The cysts can become quite large and the overlying skin becomes quite thin. They often discharge a clear jelly like fluid either spontaneously of if knocked. They can occasionally become infected.
What is the cause?
Diagnosis
Treatment options
How we treat Mucous cysts:
Surgery
Surgery involves removal of the cyst and the underlying bony spur. The operation is usually a day case procedure, which means you, can arrive and leave on the same day. It is usually performed with local anaesthetic, which means only your finger goes numb. Sometimes for large cysts the skin is turned around to cover the resulting defect, this is called a “flap”.
Wound Care
A bulky finger dressing is applied after surgery. This is to protect the finger and keep the area clean and dry. We will usually see you back in the clinic at around 7-10 days for a wound inspection. The dressing is usually removed after 10-14 days and the sutures are removed. The next appointment would be around 6 weeks. The incision/scar commonly remains tender and swollen for several weeks after surgery and can take months to fully “settle down”.
Driving
You may be able to drive once the large dressing has been removed. You need to be able to perform an emergency stop safely and use the gear stick, steering wheel and hand brake without difficulty.
What are the potential complications
Infection, Painful/tender/thickened scars and more:
The majority of patients are very satisfied with the outcome of surgery. Whilst uncommon, all surgical procedures are associated with some risks. Every effort is made to minimize these to ensure the best possible outcome from your surgery.
Infection – Uncommon occurs in approximately 1% of operations and usually treated very successfully with antibiotics. Very rarely would require further surgery
Delayed healing – Smokers and those with diabetes are more prone to this
Painful/Tender/thickened Scars – the vast majority of patients complain of some discomfort around the scar but it generally resolves with time. Wound care and desensitization as directed by your physiotherapist/hand therapist will improve this.
Nerve injury – small nerves that supply the skin around the scar may be injured giving a numb patch or unpleasant sensation round the scar. The use of magnification glasses ( Loupes) by your surgeon and very careful dissection will be used to minimise this complication
Stiffness – Operations to the finger may cause stiffness, this can be minimized by getting your hand/wrist moving as early as possible and working closely with your hand therapist if necessary.
Recurrence: This is uncommon but can occur in approximately 5 – 10 %.
CRPS – complex regional pain syndrome, this is an uncommon but serious complication. It can on rare occasions leave you with a less function hand with on-going pain stiffness and swelling. See section on CRPS. The exact incidence or rate of CRPS after surgery is unknown. It probably occurs in a significant form in approximately 1-2% of cases