gms | German Medical Science

Objectives/Interrogation: Dorsal wrist ganglia have been associated to mucoid dysplasia and anatomically related to dorsal scapholunate ligament complex. Arthroscopic treatment has lead to faster recovery and allowed simultaneous treatment of concurrent lesions during wrist assessment. High recurrence rates are nevertheless a concern. Here, the authors compare clinical results after arthroscopic treatment of dorsal wrist ganglia using arthroscopic excision alone and arthroscopic excision combined with dorsal capsulodesis.

Methods: A retrospective study included 19 patients (3 male and 16 female) with dorsal wrist ganglia submitted to arthroscopic excision (Group A, n= 10) or arthroscopic excision and dorsal capsulodesis (Group B, n= 9), between January 2011 and December 2017. Clinical evaluation included wrist range of motion, power strenght and grip strength measures. Visual Analogue Scale (VAS) for pain and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire were applied. Statistical analysis was displayed with Graph Pad Prism 6 for Windows 10.

Results and Conclusions: After 42,27±17,74 months of follow-up (range 14,97±81,81), mean range of power strength, pinch strength and range of motion values were all above 80% of the contralateral side for both groups. Post-operative pain was significantly lower for both groups (Group A: VAS 6,88±2,03 vs 1,94±2,82; Group B: VAS 6,86±2,04 vs 1,81±1,94; p<0.05). Average DASH score was 3,50±7,84 for Group A and 2,87±3,64 for Group B. There were no significant statistical differences for functional parameters between Group A and B. Recurrence rate was 30% for Group A and 11% for Group B. There were no registered complications.

Arthroscopic treatment of dorsal wrist ganglia by excision allows good functional results and significant improvement of preoperative pain with no major associated complications. According to our data, when performing routine dorsal capsulodesis simultaneously, positive results are maintained. The association of ganglionectomy and dorsal capsulodesis in our series allowed a significant lowering in recurrence rates (11%) in a short-term follow-up. We believe that dorsal scapholunate ligament complex might play a role in dorsal ganglia pathogenesis and recurrence. However, prospective studies with randomization, larger samples and longer follow-up periods are needed to validate these results.