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The Natural History of Untreated Dorsal Wrist Ganglia and Patient Reported Outcome 6 Years after Intervention

From the Glenfield Hospital, University Hospitals of Leicester, Leicester, UK

Correspondence: Mr J.J. Dias, Consultant Orthopaedic Surgeon, Glenfield Hospital, Leicester LE3 9QP, UK. Tel.: +44 116 2563089; fax: +44 116 2502676. E-mail:joseph.dias{at}uhl-tr.nhs.uk

We have evaluated the long-term outcome of excision, aspiration and no treatment of dorsal wrist ganglia prospectively in 236 (83%) of 283 patients who responded to a postal questionnaire at a mean of 70 months. The resolution of symptoms was similar between the treatment groups (p>0.3). Pain and unsightliness improved in all three treatment groups. The prevalence of weakness and stiffness altered only slightly in all three treatment groups. More patients with a recurrent, or persistent ganglion complained of pain, stiffness and unsightliness (p<0.0001). Patient satisfaction was higher after surgical excision (p<0.0001), even if the ganglion recurred. Twenty-three of 55 (58%) untreated ganglia resolved spontaneously. The recurrence rate was 58% (45/78) and 39% (40/103) following aspiration and excision, respectively. Eight out of 103 patients had complications following surgery. In this study, neither excision nor aspiration provided significant long-term benefit over no treatment.

Key Words: wrist ganglia • recurrence • outcome • natural history • surgery • aspiration

Journal of Hand Surgery (European Volume), Vol. 32, No. 5, 502-508 (2007)
DOI: 10.1016/J.JHSE.2007.05.007


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