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Recent Medical Video

Ganglion of the wrist Print E-mail

Ganglions are usually small, benign cysts filled with clear high viscosity liquid. We do not know exactly why they occur, but they appear in classic positions. Most common are areas of the wrist, which have intense friction between the tendons or increased interarticulary pressure.

Usually, they use a stem to connect to the membranes of bones of the wrist or the tendon and sheath.

70% of ganglia are on the dorsal surface of the wrist

Ganglions are not always visible outside the skin, but can also cause severe symptoms.

A ganglion feels like bulge or mass, usually in the middle of the dorsal surface of the wrist or the base of the thumb at the palmar surface of the wrist.
It can be noticed suddenly or develop slowly, while its size varies depending on how we tire our hand.


Symptoms

A ganglion can be painful, or pushing the medium or the ulnar nerve, causing numbness or weakness to the fingers. It is typical that the symptoms do not progress, i.e. they are not getting worse.

Internal ganglions can cause more intense symptoms, despite their small size.


Diagnosis

The diagnosis is set by the orthopedic and based on history taking, clinical trials and sometimes x-rays, to rule out the presence of arthritis or bone tumor.

- From the history it is investigated whether the ganglion fluctuates in size
- During the palpation of the hand, the doctor can determine the composition of the ganglion, and many times, light is used to verify if it is light transparent.
- The internal ganglions may need ultrasound or magnetic resonance (MRI) to identify.


Treatment

Ganglions have a high proportion of reappearance, i.e. recurrence.

Essentially, the reasons that lead us to dealing with them, are:
- Aesthetic
- Pain from the nerve pressure or tendon friction.

The logic of conservative management is monitoring the progress of the ganglion, breaking with a needle or suction attempt.


The surgery

If the initial conservative treatment fails, surgery is in order. The surgery is performed under local anesthesia, in a fully equipped clinic. It usually takes around 30 minutes.

The patient needs not remaining in the clinic and leaves immediately. Finger movements are encouraged immediately postoperatively.

The first wound change takes place in the medical office two days later, when a lighter bandage is fitted. The stitches are removed in two weeks time in the medical office.

You return to work almost immediately after surgery, when pain subsides and you regain the the wrist strength.


Possible complications

As in any surgery, there is always the risk of microbial infection. However, such a thing is rare and dealt with successfully with the help of antimicrobials.

A slight tenderness over the incision disappears over time.

In ganglions, there is always the possibility of reappearing in the same or a different area.

 
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