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Arthroscopic Excision of Dorsal Ganglions

  • Meredith N. Osterman
  • Joshua M. Abzug
  • A. Lee OstermanEmail author
Chapter

Abstract

Ganglion cysts about the wrist are a common pathology that presents to hand surgeons. The majority is dorsal, originating from the scapholunate ligament, but volar and occult ganglions are also common and symptomatic. Treatment options for these masses include observation, aspiration, or surgical excision. Historically, open surgical excision has been the gold standard of treatment; however, arthroscopic excision is becoming more favorable due to its minimally invasive nature and decreased postoperative recurrence rates. Concerns regarding limited visualization and volar ganglion excision exist; however, newer surgical techniques and data continue to support the arthroscopic technique. This chapter contains a video.

Keywords

Forceful Grip Ganglion Cyst Wrist Pain Scapholunate Ligament Wrist Arthroscopy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 21.1

Arthroscopic management of dorsal ganglions (MP4 58,872 kb)

References

  1. 1.
    Janzon L, Niechajev IA. Wrist ganglia. Incidence and recurrence rate after operation. Scand J Plast Reconstr Surg. 1981;15:53–6.PubMedCrossRefGoogle Scholar
  2. 2.
    Osterman AL, Raphael J. Arthroscopic resection of dorsal ganglion of the wrist. Hand Clin. 1995;11:7–12.PubMedGoogle Scholar
  3. 3.
    Luchetti R, Badia A, Alfarano M, Orbay J, Indriago I, Mustapha B. Arthroscopic resection of dorsal wrist ganglia and treatment of recurrences. J Hand Surg Br. 2000;25:38–40.PubMedCrossRefGoogle Scholar
  4. 4.
    Kang L, Akelman E, Weiss A. Arthroscopic versus open dorsal ganglion excision: a prospective, randomized comparison of rates of recurrence and of residual pain. J Hand Surg Am. 2008;33(4):471–5.PubMedCrossRefGoogle Scholar
  5. 5.
    Rizzo M, Berger R, Steinmann S, Bishop A. Arthroscopic resection in the management of dorsal wrist ganlgions: results with a minimum 2-year follow-up period. J Hand Surg Am. 2004;29:59–62.PubMedCrossRefGoogle Scholar
  6. 6.
    Edwards SG, Johansen JA. Prospective outcomes and associations of wrist ganglion cysts resected arthroscopically. J Hand Surg Am. 2009;34:395–400.PubMedCrossRefGoogle Scholar
  7. 7.
    Gude W, Morelli V. Ganglion cysts of the wrist: pathophysiology, clinical picture, and management. Curr Rev Musculoskelet Med. 2008;1:205–11.PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Angelides AC, Wallace PF. The dorsal ganglion of the wrist: its pathogenesis, gross and microscopic anatomy, and surgical treatment. J Hand Surg Am. 1976;1:228–35.PubMedCrossRefGoogle Scholar
  9. 9.
    Greenberg JA. Arthroscopic treatment of volar carpal ganglion cysts. In: Slutsky DJ, Nagle DJ, editors. Techniques in wrist and hand arthroscopy. Philadelphia, PA: Churchill Livingstone, Inc. (Elsevier); 2007. p. 188–90.Google Scholar
  10. 10.
    Greendyke SD, Wilson M, Shepler TR. Anterior wrist ganglia from the scaphotrapezial joint. J Hand Surg Am. 1992;17:487–90.PubMedCrossRefGoogle Scholar
  11. 11.
    Chen HS, Chen MY, Lee CY, et al. Ultrasonographic examination on patients with chronic wrist pain: a retrospective study. Am J Phys Med Rehabil. 2007;89(11):907–11.CrossRefGoogle Scholar
  12. 12.
    Westbrook A, Stephen A, Oni J, Davis T. Ganglia: the patient’s perception. J Hand Surg Br. 2000;25(6):566–7.PubMedCrossRefGoogle Scholar
  13. 13.
    Hwangg JJ, Goldfarb CA, Gelberman RH, Boyer MI. The effect of dorsal carpal ganglion excision on the scaphoid shift test. J Hand Surg Br. 1999;24(1):106–8.CrossRefGoogle Scholar
  14. 14.
    Cardinal E, Buckwalter KA, Braunstein EM, et al. Occult dorsal carpal ganglion: comparison of US and MR imaging. Radiology. 1994;193(1):259–62.PubMedCrossRefGoogle Scholar
  15. 15.
    Goldsmith S, Yang SS. Magnetic resonance imaging in the diagnosis of occult dorsal wrist ganglions. J Hand Surg Eur. 2008;33(5):595–9.CrossRefGoogle Scholar
  16. 16.
    Ho PC, Lo WN, Hung LK. Resection of volar ganglion of the wrist: a new technique. J Arthroscop Relat Surg. 2003; 19(2):218–21.Google Scholar
  17. 17.
    Lee B, Sawyer G, DaSilva M. Methylene blue-enhanced arthroscopic resection of dorsal wrist ganglions. Tech Hand Up Extrem Surg. 2011;15(4):243–6.PubMedCrossRefGoogle Scholar
  18. 18.
    Yao J, Trindade M. Color-aided visualization of dorsal wrist ganglion stalks aids in complete arthroscopic excision. Arthroscopy. 2011;27(3):425–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Yamamoto M, Kurimoto S, Okui N, et al. Sonography-guided arthroscopy for wrist ganglion. J Hand Surg Am. 2012;37:1411–5.PubMedCrossRefGoogle Scholar
  20. 20.
    Ho PC, Griffiths J, Lo WN, Yen CH, Hung LK. Current treatment of ganglion at the wrist. Hand Surg. 2001;6:49–58.PubMedCrossRefGoogle Scholar
  21. 21.
    Mathoulin C, Hoyos A, Pelaez J. Arthroscopic resection of wrist ganglia. Hand Surg. 2004;9:159–64.PubMedCrossRefGoogle Scholar
  22. 22.
    Thronburg LE. Ganglions of the hand and wrist. J Am Acad Orthop Surg. 1999;7:231–8.Google Scholar
  23. 23.
    Clay NR, Clement DA. The treatment of dorsal wrist ganglia by radical excision. J Hand Surg Br. 1998;13:187–91.CrossRefGoogle Scholar
  24. 24.
    Jacobs LG, Govaers KJ. The volar wrist ganglion: just a simple cyst? J Hand Surg Br. 1990;15:342–6.PubMedCrossRefGoogle Scholar
  25. 25.
    Ahsan ZS, Yao J. Complications of wrist arthroscopy. Arthroscopy. 2012;28(6):855–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Meredith N. Osterman
    • 1
  • Joshua M. Abzug
    • 2
  • A. Lee Osterman
    • 3
    Email author
  1. 1.Department of Orthopedic SurgeryThomas Jefferson University HospitalPhiladelphiaUSA
  2. 2.Department of OrthopaedicsUniversity of Maryland School of MedicineTimoniumUSA
  3. 3.The Philadelphia Hand Center, P.C.King of PrussiaUSA

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