gms | German Medical Science

Introduction: Although controversially discussed, open excision remains one of the most common forms of treatment of wrist ganglia. The purpose of our study was to evaluate the outcome of wrist ganglion excision and patients’ satisfaction.

Material and methods: 199 patients, treated with open excision of a wrist ganglion between 2003 and 2010, could be identified in the electronic database of our clinic. Patients with a minimum of 6 months follow up, a written consent, and a complete case report form were included in a retrospective study. In a standardized interview epidemiological data, comorbidities, profession, leisure activities and subjective outcome (DASH, PSAS, VAS) were assessed. Clinical examination included ROM, grip strength and scar assessment (OSAS).

Results: 73 patients could be interviewed and examined on average 55 months after surgery. 13 could not be traced, two had died, 13 declined participation because of being pain free or because of a lack of interest, 19 responded only to the questionnaire and 79 did not respond at all. The overall occurrences of wrist ganglia were as follows: 52% dorsal; 7% palmar; 9% radio-dorsal and 32% radio-palmar. When operated on the non-dominant hand, grip strength reached 93% relative to the contralateral side, on the dominant hand respectively 105%. Average total active extension-flexion arc was 129° compared to 129° on the contralateral wrist. The overall recurrence rate averaged 19%. Wrist ganglia recurred on average 23 months after surgery (4% after 6 months). Total complication rate was <3% (bleeding 1%, wound infection 2%). 94 % of the patients would undergo the same surgical procedure again. 69% of all patients reporting to have suffered pain before the surgery were pain free.

Conclusion: Despite moderate response rates for study participation, this study was able to determine benefit, risk and complications of the largest case series of wrist ganglia excisions by systematic and standardized data collection. Open excision of wrist ganglia was associated with a high patient satisfaction, minimal complication and low recurrence rate.