Excision of Ganglion Cysts

Abstract

A ganglion cyst is a common reason for an outpatient hand surgery consultation. Clinically, a ganglion presents as a visible and palpable rubbery subcutaneous mass that is mobile and tethered to an underlying structure. Although commonly asymptomatic, patients may present with pain on activity and palpation, decreased range of motion and grip strength, paraesthesia from local nerve compression, or fears of malignancy. However, this benign soft-tissue mass is often asymptomatic, and it most frequently occurs on the dorsal wrist between the third and fourth extensor compartment. Excision is warranted for patients with recalcitrant pain, aesthetic concern, associated nerve entrapment, or to rule out an alternative etiology. Although recurrence is high, surgical excision is most effective when the synovial stalk communicating the ganglia with the underlying joint capsule is removed.