Arthroscopic resection of occult dorsal wrist ganglia. 2016

Nicola Borisch
Abteilung für Handchirurgie, Plastische und Wiederherstellungschirurgie, Klinikum Mittelbaden, Baden-Baden Balg, Balger Str. 50, 76532, Baden-Baden, Germany. n.borisch@klinikum-mittelbaden.de.

BACKGROUND Arthroscopic resection of dorsal wrist ganglia has become a well-accepted practice. However, there is a paucity of results on occult ganglia in the literature. The purpose of this study is to evaluate the subjective outcomes of occult dorsal wrist ganglion cysts resected arthroscopically, and to identify and examine intraarticular findings and relate them to pre-operative MRI findings and histologies. METHODS In 39 patients, 40 wrists were treated with arthroscopic resection of an occult dorsal wrist ganglion. Radio-carpal arthroscopy and mid-carpal arthroscopy were performed, and a capsular window overlying both compartments at the level of the scapholunate interval was created. The motivation to undergo operation for all patients was pain at rest and on load. In a retrospective study by telephone interview, patients were asked for pain reduction and satisfaction with the operation. 30 patients could be reached after 28.5 months on average. RESULTS 29 of the 30 patients were content with the operation. Reduction of pain at rest and on load was significant. MRI was performed pre-operatively in all the cases and could confirm the presence of a ganglion in 31 cases. Intraoperatively, ganglion structures were identified in 25 cases. Histology showed ganglion tissue or myxoid degeneration in 12 of 26 taken samples. Histology was positive in the cases without intraoperative visualization of typical ganglion structures and without confirmation by MRI. CONCLUSIONS The results of this study confirm that a high patient satisfaction can be achieved for arthroscopic treatment of occult dorsal wrist ganglia, which seem especially amenable for arthroscopic treatment. Furthermore, the results suggest that arthroscopic resection of a dorsal capsular window can be indicated if the complaints and the clinical findings are typical for dorsal wrist ganglion, even though MRI findings may be negative.

UI MeSH Term Description Entries
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001182 Arthroscopy Endoscopic examination, therapy and surgery of the joint. Arthroscopic Surgical Procedures,Surgical Procedures, Arthroscopic,Arthroscopic Surgery,Surgery, Arthroscopic,Arthroscopic Surgeries,Arthroscopic Surgical Procedure,Arthroscopies,Procedure, Arthroscopic Surgical,Procedures, Arthroscopic Surgical,Surgeries, Arthroscopic,Surgical Procedure, Arthroscopic

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