Wrist Ganglion
It is a fluid filled cyst, which can occur alongside any joint in the hand or wrist. They arise from the soft tissue around the joint, including the joint lining, tendons or ligaments and look like a small water balloon on a stalk. They are the most common lump or swelling seen in the hand. Ganglion cysts can quickly appear, disappear, and change size. Many ganglion cysts do not require any treatment. However, if the cyst is painful, interferes with function, or has an unacceptable appearance, there are several treatment options available.
What is the cause?
Diagnosis
Diagnosis can often be made from the clinical history (the account of events and symptoms from the patient) and the clinical examination. An X-ray may show some wear and tear in the joint.
Treatment options
Here are treatment options for Wrist ganglions
Aspiration
The cyst can be drained using a needle (aspiration). This can help to improve the appearance and the symptoms of pain, but has a high chance that the cyst will regrow or recur.
Surgery
Surgery involves removal of the cyst. The operation is usually a day case procedure, which means you can arrive and leave on the same day. Depending on the location of the ganglion, surgery is carried out under either local or regional (i.e. with you awake but with the digit or arm numb) or under general anaesthetic (with you asleep).
Wound Care
Surgery involves removal of the cyst. The operation is usually a day case procedure, which means you can arrive and leave on the same day. Depending on the location of the ganglion, surgery is carried out under either local or regional (i.e. with you awake but with the digit or arm numb) or under general anaesthetic (with you asleep).
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:
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