Clin Orthop Surg.  2011 Jun;3(2):152-156. 10.4055/cios.2011.3.2.152.

Ganglionectomy without Repairing the Bursal Defect: Long-term Results in a Series of 124 Wrist Ganglia

• Dermon A
• Kapetanakis S
• Fiska A
• Alpantaki
• Kazakos K

• KMID: 1719313
• DOI: http://doi.org/10.4055/cios.2011.3.2.152

Abstract

BACKGROUND
Some surgeons consider the abscission of a part of the articular bursa around the point of the input of ganglion's nape (average 1-2 cm diameter) to be very important with excellent results. However, a literature search revealed disagreement as to whether it is essential to repair a bursa defect. This study examined the effectiveness of this method without repairing the articular defect. An attempt was made to identify the anatomical origin of wrist ganglia during the surgical procedure.
METHODS
This study evaluated 124 wrist ganglia that had been treated surgically during 2004-2009 using this technique and without repairing the bursa defect (1-2 cm in diameter). The variables studied were age, gender, time from the occurrence till abscission of the ganglia, former surgical interventions, preoperative and postoperative pain, insertion of the ganglion's nape and complications. Sixty-six patients with a mean follow-up of 42 months and minimum 12 months were examined.
RESULTS
At the time of the follow-up, 80.3% had no pain whereas 92.2% showed a remarkable improvement. Seven cases of recurrence (10.6%) were found 2 to 85 months after surgery, of which most appeared during the first year (71.4%). It is important to mention that the majority of the dorsal ganglia (42.8%) originated from the capitate-lunate joint. None of the patients presented with scapholunate or other instability.
CONCLUSIONS
This surgical method is a simple and safe with excellent long-term results and a lower recurrence rate compared to other surgical approaches. Overall, repair of the articular bursa is unnecessary.

Keyword

Wrist ganglia; Dorsal; Volar; Excision

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Bursa, Synovial/*surgery
Female
Humans
Ligaments, Articular/pathology
Male
Middle Aged
Recurrence
Synovial Cyst/pathology/*surgery
Wrist/*surgery
Young Adult

Figure

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  Fig. 1 Origin of ganglia.

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  Fig. 2 Origin of dorsal ganglia. Lig: ligament.

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  Fig. 3 Origin of volar ganglia.

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  Fig. 4 Number of complications.

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