gms | German Medical Science

Objective: When patients with a ganglion wrist cyst suffer from pain or physical impairment, the preferred method of treatment is surgical removal (Wiedrich & Osterman, 2003; Athanasian, 2016). Until now there is no consistency in types of immobilisation and therapy that patients receive after surgical removal. It is unknown what the optimum length of immobilisation is after surgery to provide the most improvement on physical function and/or satisfaction. An extended critical literature search and review was performed to investigate the optimum length of time of immobilisation after surgical removal of a ganglion wrist cyst.

Materials and Methods: Literature search identified 3,943 studies. With the use of in-/exclusion criteria 14 articles were included, all case studies level 4 (CEBM, 2016). These articles discus the optimum length of time of immobilisation and therapy after a ganglion resection. An extended critical literature review was performed (Downs & Black (1998).

Results: Immobilisation for less than seven days after a resection of the wrist ganglion has the best outcomes; less chance of recurrence, less complications, less stiffness and less pain (Chung & Tay, 2015; Kang, et al., 2013). Furthermore, when patients start with therapy three weeks after surgery, they also have a lower chance of recurrence (Balazs, et al., 2015; Chung & Tay, 2015; Kang, et al., 2013; Kim, et al., 2013). The outcomes of the literature review are presented in an evidence bases therapy guideline for treatment after a ganglion resection.

Conclusions: Given the consistency of the outcome measurements present in the included studies, a comparison of the data could be made. However, due to the poor methodological quality of the included articles (level 4 CEBM, 2016) no systematic review could be performed. Nevertheless, further research is necessary in the form of a trial to define the precise days of immobilisation and the type of immobilisation that gives the optimum results.