Wrist Ganglion: Current Review of Literature for Pathogenesis and Treatment

Joo-Hak Kim

doi:10.12790/jkssh.2016.21.4.173

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Kim: Wrist Ganglion: Current Review of Literature for Pathogenesis and Treatment

REVIEW ARTICLE

J Korean Soc Surg Hand 2016;21(4):173-180.

Published online: 11 December 2016

DOI: https://doi.org/10.12790/jkssh.2016.21.4.173

Wrist Ganglion: Current Review of Literature for Pathogenesis and Treatment

Joo-Hak Kim

Department of Orthopaedic Surgery, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea

Correspondence to: Joo-Hak Kim, Department of Orthopaedic Surgery, Myongji Hospital, Seonam University College of Medicine, 55 Hwasu-ro 14beon-gil, Deokyang-gu, Goyang 10475, Korea, TEL: +82-31-810-6530, FAX: +82-31-969-0500, E-mail: wind_123@hanmail.net

Received 24 May 201629 November 2016 Accepted 30 November 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Ganglion cysts are benign soft tissue tumors most commonly encountered in hand and wrist. Sixty to seventy percent of these are found in the dorsal aspect of the wrist. They are more common in the twenties to forties and in female. Its origin and pathogenesis remain unproved and there are several theories for genesis of ganglion. Non-surgical treatment is unreliable with a high recurrence rates. Open surgical excision is still golden standard treatment for wrist ganglion. Recently Arthroscopic excision has been tried to reduce unsightly scar and some complications, but still has some limitations. We reviewed the current literature available on wrist ganglion.

Keywords: Wrist, Hand, Ganglion, Pathogenesis, Treatment

REFERENCES

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Fig. 1.

Arthroscopic visualization of the dorsal ganglion through the 4–5 portal (A). We can see the redundant material of scapholunate ligament (B), through which arthroscopic resection of hemorrhagic ganglion wall (C) has been performed (D).

Fig. 2.

Arthroscopic visualization through the 3–4 portal. We can see the redundant material and synovitis between radioscaphocapitate ligament and long radiolunate ligament (A), through which arthroscopic resection (B) has been performed (C).

Table 1.

Expectant management

Study	Spontaneous resolution (%)	Follow-up
Westbrook et al.¹⁴	45	4 mo
McEverdy⁶	48	12 yr
Dias and Buch¹⁹	53	2 & 5 yr
Average	49	-

Table 2.

Review of studies of non-surgical treatment of wrist ganglion

Method	Recurrence rate (%)	Follow-up
Aspiration only
1. Varley²³	67	4 mo
2. Zubowicz and Ishii¹⁶	15 (multiple)	1 yr
3. Westbrook et al.¹⁴	49	6 wk
Aspiration and steroid
1. Derbyshire²²	14	2 mo-5 yr
2. Paul and Sochart²⁵	51
3. Wright et al.³²	83
4. Breidahl and Adler¹⁰	60
Aspiration with hyalurnidase
1. Otu²⁴	5	6 mo
2. Paul and Sochart²⁵	51	2 yr
Aspiration and sclerosant
1. McEvedy²⁷	18	13 yr
2. Mackie et al.²⁸	93	3 mo
Aspiration with multiple puncture
1. Stephen et al.²⁰	78
2. Richman et al.²⁶	64	22 mo
3. Korman et al.¹⁷	49	12 mo

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