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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Surgical Treatment of DIP Ganglion by Excision and DIP Synovectomy without Skin Flap: 10 Cases

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  • presenting/speaker Romina Lachenmeier - Spitalzentrum Biel, Bienne, Switzerland
  • Helen Segmüller - Spitalzentrum Biel, Bienne, Switzerland

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1869

doi: 10.3205/19ifssh0864, urn:nbn:de:0183-19ifssh08646

Published: February 6, 2020

© 2020 Lachenmeier et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: To show that surgical treatment of ganglion cysts (mucous cysts) of the DIP joint can be done with careful complete excision of the ganglion and stalk resection combined with dorsal synovectomy. A small area of thin skin overlying the cyst can be resected and left open. No skin flap is necessary.

Methods: Retrospective review of 10 cases. Mean follow-up time is 25 months. There were 8 index and 2 middle fingers. Mean age is 60 years.

Surgical technique: All operations were performed in axillary block anaesthesia, with upper arm tourniquet.

The incision was Y-shaped, centered dorsally over the DIP joint. The ganglion with the stalk coming from the DIP joint was carefully excised. In cases with very thin skin overlying the ganglion maximally 3x3 mm of the skin were excised and left open for spontaneous granulation.

Results and Conclusions: After a mean follow-up of two years all of the 10 operated patients showed normalized nail growth, no scarring, a good aesthetic result, good ROM, no recurrence of the ganglion.

The surgical treatment of DIP ganglion cysts needs to consist of careful resection of the cyst with the stalk and dorsal synovectomy. In some cases resection of a small area of thin skin overlying the ganglion is necessary. This area can be left open, coverage with skin flaps is not necessary.