HAND

Hand surgery requires consideration of the entire hand up to the shoulder as an interconnected unit because of its' unique complexity and intricacy. Whether treating fractures, arthritis, or deformities, a hand surgeon considers the entire hand, wrist, forearm, arm, and shoulder. The hand specialists at Lowcountry Orthopaedics treat conditions involving the bones, tendons, and muscles of the hands, wrist, elbow, shoulder, arm and forearm.

GANGLION OF THE WRIST

WHAT IS A GANGLION CYST?

The most common mass on the wrist and hand. These fluid-filled cysts can quickly appear, disappear, and change size. A ganglion typically grows out of joint tissues out of a joint, like a balloon on a stalk. Inside the balloon is a jelly-like fluid. Ganglion cysts can develop on both the top and underside of the wrist, the end joint of a finger, and at the base of a finger. They vary in size, and in many cases, grow larger with increased wrist activity. With rest, the lump typically becomes smaller. It is not known what causes a ganglion. They are most common between the ages of 15 and 40 years, and women are more likely to be affected. These cysts are common among gymnasts, who repeatedly stress the wrist.

WHAT ARE THE SYMPTOMS?

  • Pain with pressure on the wrist or making a fist
  • Sometimes numbness into the wrist and forearm
  • A swollen area or visible lump

WHAT MEDICAL TESTS WILL I NEED?

  • X-Rays: to rule out any abnormal bone structures that might be causing your symptoms.
  • MRI: to look at soft tissues like a ganglion.

HOW IS IT TREATED?

  • Braces: allows the swollen tissues to rest.
  • Anti-inflammatory Medicine: controls swelling in the wrist. These include naproxen, ibuprofen, and meloxicam
  • Aspiration: dorsal ganglia may be drained in office using a needle. Half the time, the cyst will come back.
  • Surgery: the goal is to remove the cyst. The tissue that is removed will be sent to a pathologist to rule out cancer.

WHAT DO I NEED TO KNOW ABOUT SURGERY?

  • You will be contacted within 2 weeks of your pre-op visit for pricing and scheduling.
  • The surgery will last less than 45 minutes and you will go home the same day.
  • You will have a dressing and/or splint for 2 weeks that will keep your wrist from moving. After the splint is removed, the are no restrictions on movement.
  • You will typically not be able to lift with that hand until 4 weeks after surgery. If the cyst is only on your finger, you will be able to lift right after surgery.
  • Your surgeon will make small incision over the cyst and remove the capsule and the stalk.
  • The bandage over the incision should be kept clean and dry.
  • At your 2 week follow up visit, the sutures and splint will be removed, and you will begin scar massage.
  • If you are having symptoms in the other hand, you will be given the option to have surgery at your 4 week follow up.
Reproduced from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.

Katy Blair Conner, MS, MSPAS, PA-C

 BROCHURE: GANGLION OF THE WRIST