Hand Surgery

Ganglion, Cysts

Development

Ganglions are benign cyst-like blastomas in the joint or carpal tunnel vicinity. They appear most commonly on the stretch side of the wrist. The cause is unknown. Given that there are various other blastomas (gout and rheumatic knots, lipomas, malignant tumors...) that may appear on the hand, the diagnosis should be made by a physician.
A ganglion is the result of the protruding of the joint capsule or a bubble-like extension of the carpal tunnel. The content is typically gel-like and is produced by the joint skin (synovia). In the wrist area, ganglions may in particular be located in the bone (e.g. lunar bone, scaphoid bone). Consequently, X-rays of wrist ganglions should be taken for safety reasons.

Symptoms

Initially, a swelling appears in the form of a small mound. It may increase or decrease in size. The most frequent symptom is motion pain, which may be combined with movement limitations in extreme cases. If the ganglions are located in the proximity of nerves, they may interfere with the sensation functions in this area. However, many patients do not have any pain.

Treatment

Ganglions are harmless blastomas. If a ganglion has been present for just 2-3 months without any pain, it is best to leave it be and wait. Surgery should be performed only if the patient is suffering from pain or if there are cosmetic deformations. If the area is tapped, the re-occurrence rate is around 50%. To minimize the probability of reappearance of the ganglion, a plaster cast may be applied after surgery until wound healing is complete.