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Bultos y protuberancias en la mano, la muñeca y los dedos

Found a lump on your hand, wrist or finger? The common causes and what they mean: ganglion cysts, fatty lumps (lipomas), giant cell tumours, mucous cysts and carpal bossing, and when to see someone.

Updated Sep 2026
La parte posterior de la muñeca presenta un quiste ganglionar redondo y liso.
La mayoría de los bultos en la mano y la muñeca son benignos. Los quistes ganglionares son los más frecuentes; sin embargo, cualquier bulto nuevo merece ser evaluado. Kieran Hirpara 4.0

Esta página se tradujo automáticamente y todavía no la ha revisado un médico. La versión en inglés es la versión oficial.

Qué está sintiendo

Un bulto en la mano, la muñeca o el dedo suele ser un quiste ganglionar. Se trata de una bolsa llena de líquido que se forma cerca de una articulación o de un tendón. Puede sentirse firme o blando, y su tamaño puede variar. Algunos bultos duelen; otros no causan ningún dolor.

La ubicación del bulto determina qué síntomas se experimentan. Un bulto en el dorso de la muñeca puede doler al doblar la muñeca hacia atrás o al apoyar la mano para levantarse de una silla. Un bulto en la cara palmar de la muñeca puede ejercer presión sobre las estructuras cercanas, provocando molestias al agarrar objetos. Un bulto en un dedo, cerca de la articulación media, puede impedir o dificultar el movimiento al doblar el dedo, lo que dificulta abrochar botones, usar cremalleras o sostener un bolígrafo.

El dolor suele intensificarse después de usar la mano: levantar objetos pesados, agarrar cosas repetidamente o pasar un día entero tecleando pueden empeorarlo. El descanso suele aliviarlo. Algunas personas notan el bulto más durante la noche o al despertar, cuando la mano ha permanecido inmóvil durante horas.

Las tareas cotidianas pueden volverse incómodas: girar un picaporte, llevar bolsas de la compra, escurrir un paño o sostener una taza de café pueden ejercer tensión sobre el bulto. Si el bulto está cerca de un tendón en un dedo, estirar ese dedo puede resultar difícil o lento.

La mayoría de estos bultos son inofensivos. Algunos se reducen o desaparecen por sí solos, especialmente en niños. En niños menores de 10 años, los quistes ganglionares suelen aparecer en la cara palmar de la muñeca, y entre el 69 % y el 79 % desaparecen espontáneamente en un plazo de 12 a 18 meses.

No es necesario apresurarse a recibir tratamiento. Observe cómo se comporta el bulto durante unas semanas: cuándo duele, qué lo empeora y si crece. Este historial ayudará a su médico a determinar de qué se trata el bulto y si es preciso realizar alguna intervención.

¿Qué ocurre en realidad?

Un quiste ganglionar se forma cuando el líquido procedente de una articulación o de la vaina tendinosa cercana (el “túnel” que guía al tendón, similar a cómo una polea guía una cuerda) se filtra por un punto débil y se acumula bajo la piel. Imagíneselo como un pequeño “globo” lleno de un líquido espeso y gelatinoso situado en una zona móvil del cuerpo. Este “globo” en sí es inofensivo, pero ocupa espacio. Por eso, al doblar la muñeca o el dedo se siente rigidez o dificultad para moverlos, y por qué el bulto puede doler tras usar la mano.

La ubicación del quiste es importante. Un quiste en el dorso de la muñeca se encuentra cerca de los pequeños huesos y ligamentos que permiten el movimiento de flexión y rotación de la muñeca. Uno en la palma, en cambio, está próximo a nervios y vasos sanguíneos, por lo que puede ejercer presión sobre ellos a medida que crece. Los quistes en los dedos suelen formarse junto a la vaina tendinosa, motivo por el cual al estirar o doblar ese dedo se siente cierta resistencia.

No todo bulto es un quiste ganglionar. Algunos son acumulaciones de grasa bajo la piel; suelen ser blandos y crecen lentamente. Otros se originan en el hueso o en el revestimiento del tendón, y suelen ser más firmes al tacto. Un examen detallado del dedo afectado ayuda a diferenciar un quiste ganglionar dentro de una vaina tendinosa, un dedo en gatillo (dedo que “clicca” o se bloquea) y la enfermedad de Dupuytren (endurecimiento del tejido de la palma que tira de los dedos hacia dentro).

En los niños, estos bultos se comportan de manera distinta. Los quistes en la mano desaparecen con mayor frecuencia que los de la muñeca, y la mayoría de los menores de 10 años responden bien a un simple seguimiento clínico en lugar de a la cirugía.

Por lo general, este bulto no es peligroso. No obstante, puede crecer, ejercer presión sobre estructuras cercanas o seguir provocando dolor; en esos casos, merece la pena considerar un tratamiento.

Qué podemos hacer al respecto

Muchos bultos desaparecen sin necesidad de ningún tratamiento. Si su bulto es pequeño y no duele, observarlo y esperar es un primer paso razonable. Una férula puede ayudar a descansar una muñeca o un dedo doloridos y reducir la presión sobre el bulto. Los movimientos suaves evitan que la mano se vuelva rígida mientras se espera. Algunos bultos se reducen o desaparecen por sí solos; por eso, conviene probar estas medidas sencillas durante unas semanas antes de optar por otras soluciones.

Si el bulto duele, los comprimidos o geles antiinflamatorios pueden aliviar el malestar. Estos medicamentos reducen la inflamación y el dolor. Una inyección de cortisona también puede disminuir la inflamación en el tejido circundante al bulto. En algunos casos, se puede drenar el líquido con una aguja; este procedimiento se conoce como aspiración. Con frecuencia, el bulto se aplana rápidamente, aunque los quistes ganglionares pueden volver a llenarse después. En el caso de un quiste ganglionar en el dorso de la muñeca, resulta sensato intentar al menos una aspiración antes de considerar la cirugía.

Si el bulto sigue creciendo, sigue doliendo o comprime algún nervio, merece ser evaluado. Su médico lo examinará y, posiblemente, solicitará estudios de imagen para determinar su composición y ubicación. Algunos bultos no son quistes ganglionares en absoluto. Un bulto duro en el dorso de la muñeca podría ser un espolón óseo derivado de la artritis degenerativa; estos suelen tratarse primero sin cirugía, mediante férulas, antiinflamatorios e inyecciones dirigidas. En el caso de los quistes ganglionares, la cirugía tiene como objetivo extirpar todo el bulto junto con su tallo, el pequeño conducto que lo conecta a la articulación; dejar ese conducto intacto aumenta la probabilidad de que el quiste reaparezca. Algunos procedimientos se realizan mediante pequeñas incisiones y una minicámara dentro de la articulación, lo que implica menos daño al tejido circundante.

La opción adecuada depende de qué tipo de bulto sea, dónde se encuentre y cuánto le moleste. Lleve consigo sus notas sobre cuándo le duele y qué factores lo empeoran. Ese historial, junto con el examen clínico, le ayudarán a usted y a su médico a decidir si lo más conveniente es observarlo, drenarlo, inyectarle medicación o extirparlo.

Qué esperar

La mayoría de los bultos en la mano y la muñeca son inofensivos, y muchos desaparecen sin necesidad de tratamiento. Algunos se reducen o desaparecen por sí solos, especialmente en niños. Otros mantienen el mismo tamaño o aparecen y desaparecen a lo largo de varios meses. Si el bulto le duele después de usar la mano, el reposo y medidas sencillas suelen aliviarlo en unas pocas semanas.

Si se drena el bulto con una aguja, con frecuencia se aplana rápidamente. Los quistes ganglionares pueden volver a llenarse después, por lo que intentar al menos una drenaje antes de la cirugía es un enfoque razonable para un bulto en el dorso de la muñeca. Si la cirugía elimina por completo el bulto junto con su tallo, la probabilidad de que reaparezca es menor; dejar esa conexión implica un mayor riesgo de recurrencia.

Algunos bultos no son quistes ganglionares. Un bulto duro en el dorso de la muñeca puede ser un espolón óseo derivado de la artritis por desgaste. Por lo general, estos espolones se tratan sin cirugía al principio; sin embargo, incluso tras una intervención quirúrgica, los síntomas pueden persistir. Es importante tener esto en cuenta antes de tomar cualquier decisión.

Si el bulto se debe a inflamación del revestimiento tendinoso, como ocurre en ciertas formas de artritis, el pronóstico depende de controlar la enfermedad subyacente. El uso de férulas puede aliviar el dolor. Una inyección dirigida al tejido inflamado resulta más eficaz que los comprimidos para tratar una zona afectada de forma aislada. Eliminar ese revestimiento inflamado puede reducir el dolor y proteger los tendones; además, una hinchazón que persista durante 6 semanas o más a pesar del tratamiento médico adecuado podría ser motivo para considerar dicha intervención.

En el caso de los crecimientos grasos y otros bultos de tejido blando, extirpar el bulto por completo suele resolver los síntomas que provoca. Algunos de estos bultos pueden reaparecer si queda algún tejido residual; por eso es fundamental una extirpación total.

Sea cual sea el tipo de bulto, el objetivo final es contar con una mano que funcione para las actividades que usted necesita realizar. Algunas personas no requieren ningún tratamiento; otras necesitan férulas, inyecciones o cirugía para lograrlo. Una vez identificado el bulto, su médico le explicará cuál es el pronóstico específico para su caso.

¿Cuándo consultar a un profesional?

La mayoría de los bultos son inofensivos, pero existen ciertos signos que indican que es momento de hacerse una evaluación. Acuda a su médico de cabecera si un bulto crece rápidamente, se vuelve doloroso o presenta cualquier cambio. Solicite una valoración por parte de un especialista si el bulto reaparece tras haber sido drenado, o si ejerce presión sobre un nervio y provoca entumecimiento, hormigueo o debilidad en los dedos. Diríjase a urgencias si su mano se vuelve caliente, roja e hinchada, con enrojecimiento que se extiende, o si presenta fiebre; estos síntomas pueden indicar una infección que requiere atención inmediata. El entumecimiento repentino, el cambio de color o la sensación de frío en los dedos también requieren evaluación urgente. Si un bulto se siente duro y fijo, en lugar de blando y móvil, solicite una valoración especializada para identificarlo adecuadamente.


Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

Diagnostic Differentiation

  • A detailed physical examination of the MCP region of the affected digit can distinguish between a flexor sheath ganglion, trigger digit, and Dupuytren's nodule [1].

Pediatric Ganglions

  • In children aged <10 years, ganglions mainly occur on the volar wrist [3].
  • In children aged <10 years, 69% to 79% of volar wrist ganglions display spontaneous regression within a span of 12-18 months [3].
  • Pediatric ganglions of the hand have a greater rate of resolution than ganglions of the wrist [5].

Dorsal Wrist Ganglion Management

  • Performing at least 1 aspiration before surgical excision improves the cost-effectiveness of dorsal wrist ganglions treatment [2].
  • Hand surgeons are divided regarding the need to immobilize the wrist after dorsal wrist ganglion excision [4].
  • Routine midcarpal joint exploration during arthroscopic excision of dorsal wrist ganglions appeared to reduce recurrence at 1 year without negatively impacting patient outcomes [6].
  • Open surgery continues to be an ineffective way of managing cystic soft tumours of the dorsal aspect of the wrist due to high recurrence rates [7].
  • Higher postoperative pain intensity following dorsal wrist ganglion excision was associated with recurrence following previous surgery [8].
  • Higher postoperative pain intensity following dorsal wrist ganglion excision was associated with treatment of the dominant hand [8].
  • Higher postoperative pain intensity following dorsal wrist ganglion excision was associated with higher baseline pain intensity [8].
  • Higher postoperative pain intensity following dorsal wrist ganglion excision was associated with lower credibility the patient attributes to the treatment [8].
  • Higher postoperative pain intensity following dorsal wrist ganglion excision was associated with longer symptom duration [8].

Rare Tumors and Anatomic Variations

  • Giant cell tumors of the distal phalanx are extremely rare [9].
  • Giant cell tumors of the distal phalanx require extensive en bloc excision to prevent local recurrence [9].
  • Digit-sparing operations for giant cell tumors of the distal phalanx may fail to eradicate all tumor foci [9].
  • Giant spindle cell lipoma involving a finger is a rare variant reported due to its unusual location [10].
  • Awareness of anatomic variations such as a persistent median artery with a reversed palmaris longus and volar ganglion is valuable for surgeons operating on the upper extremity [11].
  • Marginal excision appears to result in a good outcome with no recurrence at short- to medium-term follow-up for parosteal lipomas of the phalanges [13].

Background & Causes

Diagnostic History and Examination

  • A careful history suggests the correct diagnosis in approximately 90% of patients with hand problems [14].
  • The patient’s hand dominance, age, gender, occupation, and hobbies requiring hand dexterity or strength should be noted during the history [14].
  • The approximate date of onset of symptoms and, if injury is the cause, the exact date and mechanism of injury should be recorded [14].
  • Patients should be questioned about prior treatment and their perception of its effectiveness [14].
  • Complaints regarding the nature of pain (sharp, aching, dull, or burning), night symptoms, aggravating and relieving factors, and timing relative to morning or end-of-day work should be detailed [14].
  • Symptoms including numbness or tingling indicate a neurologic problem rather than a mechanical one [14].
  • Specific motor difficulties, such as difficulty in writing or unscrewing jar tops, should be noted [14].
  • The medical history should include prior hand injuries and systemic diseases such as rheumatoid arthritis, diabetes, endocrine disorders, renal disease, or vascular disease [14].
  • Women of childbearing age should be questioned about recent pregnancies [14].
  • Examination of the hand should begin with observation to assess vascular condition by noting finger color and nerve function by observing sudomotor function [14].
  • The extent and timing of injury are suggested by the degree of swelling and ecymosis [14].
  • The posture of the digits and wrist may signal tendon or bone disruption [14].
  • A diagram of the hand is helpful in documenting abnormalities such as lumps, laceration sites, previous scars, amputated fingers, and areas of decreased sensation [14].
  • The hand, wrist, and forearm are gently palpated to note temperature, moisture, and areas of tenderness [14].
  • Circulation is assessed by capillary refill, where circulation should return within 3 seconds when the skin is blanched in the paronychial region [14].
  • Passive and active range of motion of the shoulder, elbow, forearm, wrist, and hand are evaluated [14].
  • The integrity of individual muscles should be documented during the examination [14].

Pediatric Ganglions

  • Pediatric ganglions can be treated expectantly, with 69% to 79% displaying spontaneous regression within a span of 12-18 months [3].

Dorsal Wrist Ganglions

  • Cystic soft tissue tumours of the dorsal aspect of the wrist have two distinct histological subtypes [7].
  • Higher postoperative pain intensity was associated with recurrence following previous surgery, treatment of the dominant hand, higher baseline pain intensity, lower credibility the patient attributes to the treatment and longer symptom duration [8].

Volar Wrist Ganglions

  • Operation-related complications after arthroscopic volar wrist ganglionectomy are associated with anatomical location distal to the bifurcation of the radial artery and concurrently penetrated up to the superficial fascia layer [33].

Other Lumps and Bumps

  • Distinguishing between a flexor sheath ganglion, trigger digit, and Dupuytren's may be accomplished with a detailed physical examination of the MCP region of the affected digit [1].
  • Giant cell tumors of the distal phalanx are extremely rare and require extensive en bloc excision to prevent local recurrence [9].
  • Digit-sparing operations may fail to eradicate all tumor foci in giant cell tumors of the distal phalanx [9].
  • An angiolipoma of the hand can be a cause of carpal tunnel syndrome [12].

Management

Diagnostic Evaluation

  • A detailed physical examination of the MCP region can distinguish between a flexor sheath ganglion, trigger digit, and Dupuytren's nodule [1].
  • Patients presenting with swelling along an affected tendon sheath, most commonly as a dorsal wrist mass, may have rheumatoid tenosynovitis, which feels irregular and diffuse compared to well-defined ganglia [18].
  • Painful dorsal wrist swelling may be the presenting symptom in rheumatoid arthritis, where tenosynovial swelling can contribute to de Quervain disease, trigger finger, or carpal tunnel syndrome [20].

Non-Operative Management

  • In children aged <10 years, ganglions mainly occur on the volar wrist and can be treated expectantly, with 69% to 79% displaying spontaneous regression within a span of 12-18 months [3].
  • Performing at least 1 aspiration before surgical excision improves the cost-effectiveness of dorsal wrist ganglion treatment, as patient preferences may preclude routinely performing 2 aspirations [2].
  • Patients who received steroids at the time of aspiration perceived lower rates of recurrence for dorsal carpal ganglions [29].
  • Conservative management in rheumatoid tenosynovitis of the hand and wrist requires rheumatologic support for systemic pharmacologic management, with splinting serving an adjunctive role to relieve pain [18].
  • Targeted corticosteroid injection into the tenosynovial inflammation is more effective than the administration of systemic corticosteroids for isolated tenosynovitis [18].
  • Scar massage is widely used by hand therapists, though few respondents had received formal skills training or completed outcome measures regularly to formally evaluate its clinical efficacy or impact [15].

Operative Management

  • Higher postoperative pain intensity following dorsal wrist ganglion excision was associated with recurrence following previous surgery, treatment of the dominant hand, higher baseline pain intensity, lower credibility the patient attributes to the treatment, and longer symptom duration [8].
  • Giant cell tumors of the distal phalanx require extensive en bloc excision to prevent local recurrence, as digit-sparing operations may fail to eradicate all tumor foci [9].
  • Both curettage and resection/amputation are acceptable treatment options for giant cell tumour of bone in the hand, with treatment decisions individualized based on site and extent of disease to minimize morbidity while maximizing disease control [30].
  • Surgical treatment for rheumatoid tenosynovitis involves removing the inflamed tenosynovium while preserving normal structures, a procedure shown to decrease pain and improve disease outcomes [18].
  • Dorsal synovectomy of the wrist may be of lasting benefit if synovitis is moderate, bone changes are absent, but pain is significant, and persistent swelling continues for 6 weeks or longer despite adequate medical treatment [20].
  • Dorsal synovectomy may be considered a prophylactic measure to avoid extensor tendon rupture in rheumatoid arthritis [20].
  • Palmar (flexor) tenosynovectomy may be useful in relieving pain and preventing tendon rupture if hypertrophy of the volar wrist tenosynovium is obvious clinically with or without symptoms of median nerve compression [20].
  • Surgical intervention for the rheumatoid wrist should be considered if the carpus is subluxated with a prominent ulna associated with local synovitis of the ulnar tendons and/or distal radioulnar joint [21].
  • The indication for rheumatoid wrist surgery is mainly based on clinical and radiographic findings, with wrist stabilization given precedence even for oligosymptomatic patients when relevant risk factors for future deterioration are present [21].

Key Considerations

Diagnosis and Differential Diagnosis

  • Awareness of anatomic variations such as a persistent median artery with a reversed palmaris longus is valuable for surgeons operating on the upper extremity [11].

Pediatric Ganglions

Dorsal Wrist Ganglion Management

  • Performing at least 1 aspiration before surgical excision improves the cost-effectiveness of dorsal wrist ganglion treatment [2].
  • Open surgery is suggested to be an ineffective way of managing cystic soft tumours of the dorsal aspect of the wrist due to high recurrence rates [7].

Rare Tumors and Masses

  • Resection followed by wrist arthrodesis and structural iliac bone graft for giant cell tumor of the distal radius achieved satisfactory oncologic and functional results [16].
  • One-third of all patients experienced some complications at a minimum of 10 years of follow-up after resection and wrist arthrodesis for giant cell tumor of the distal radius [16].

Key Evidence

  • [L4] Distinguishing between a flexor sheath ganglion, trigger digit, and Dupuytren's may be accomplished with a detailed physical examination of the MCP region of the affected digit. [1] (10.1177/15589447221109644)
  • [L2] As patient preferences may preclude routinely performing 2 aspirations, performing at least 1 aspiration before surgical excision improves the cost-effectiveness of dorsal wrist ganglions treatment. [2] (10.1016/j.jhsa.2022.09.002)
  • [L4] In children aged <10 years, ganglions mainly occur on the volar wrist and can be treated expectantly, with 69% to 79% displaying spontaneous regression within a span of 12-18 months. [3] (10.1016/j.jhsa.2021.12.015)
  • [L2] The systematic review and survey of Canadian hand surgeons reveal that hand surgeons are divided regarding the need to immobilize the wrist after dorsal wrist ganglion excision. [4] (10.1177/15589447211014631)
  • [L4] Pediatric ganglions of the hand have a greater rate of resolution than ganglions of the wrist. [5] (10.1016/j.jhsa.2023.07.002)
  • [L3] Routine midcarpal joint exploration during arthroscopic excision of dorsal wrist ganglions appeared to reduce recurrence at 1 year without negatively impacting patient outcomes. [6] (10.1177/17531934251405730)
  • [L4] The authors suggest that open surgery continues to be an ineffective way of managing cystic soft tumours of the dorsal aspect of the wrist due to high recurrence rates. [7] (10.1177/17531934241251721)
  • [L2] Higher postoperative pain intensity was associated with recurrence following previous surgery, treatment of the dominant hand, higher baseline pain intensity, lower credibility the patient attributes to the treatment and longer symptom duration. [8] (10.1177/17531934231153029)
  • [L4] Giant cell tumors of the distal phalanx are extremely rare and require extensive en bloc excision to prevent local recurrence, as digit-sparing operations may fail to eradicate all tumor foci. [9] (10.1016/j.jhsa.2020.04.005)
  • [Case_report] The case is reported due to the unusual location of a rare variant of giant lipoma involving a finger. [10] (10.1055/s-0040-1721879)
  • [L4] Awareness of such anatomic variations is valuable for surgeons operating on the upper extremity. [11] (10.1016/j.jhsg.2022.04.005)
  • [L4] This case is the first report of an angiolipoma as a cause of carpal tunnel syndrome. [12] (10.1016/j.jhsg.2022.05.006)
  • [L4] Marginal excision appears to result in a good outcome with no recurrence at short- to medium-term follow-up for parosteal lipomas of the phalanges. [13] (10.1016/j.jhsa.2020.10.029)
  • [L4] Whilst scar massage was widely used, few respondents had received formal skills training or completed outcome measures regularly to formally evaluate its clinical efficacy or impact. [15] (10.1177/17589983231205666)
  • [L2] Resection followed by wrist arthrodesis and structural iliac bone graft achieved satisfactory oncologic and functional results, albeit with one-third of all patients experiencing some complications at a minimum of 10 years of follow-up. [16] (10.1097/corr.0000000000003738)
  • [L3] Patients who received steroids at the time of aspiration perceived lower rates of recurrence. [29] (10.1016/j.jhsg.2023.06.007)
  • [L4] Both curettage and resection/amputation are acceptable treatment options for the rare condition of giant cell tumour of bone in the hand, with a need to individualize treatment decisions based on the site and extent of disease to minimize treatment morbidity while maximizing disease control. [30] (10.1177/17531934211007820)
  • [L3] The operation-related complications after arthroscopic volar wrist ganglionectomy are associated with its anatomical location: distal to the bifurcation of the radial artery and concurrently penetrated up to the superficial fascia layer. [33] (10.1186/s12891-025-08766-x)

References

[1] A Simple Physical Exam Maneuver to Distinguish Trigger Digit, Dupuytren’s Nodule, and Flexor Sheath Ganglion. HAND. 2022. DOI: 10.1177/15589447221109644

[2] Minimizing Costs for Dorsal Wrist Ganglion Treatment: A Cost-Minimization Analysis. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2022.09.002

[3] Pediatric Ganglions of the Hand and Wrist: A Review of Current Literature. The Journal of Hand Surgery. 2022. DOI: 10.1016/j.jhsa.2021.12.015

[4] Immobilization of the Wrist After Dorsal Wrist Ganglion Excision: A Systematic Review and Survey of Current Practice. HAND. 2021. DOI: 10.1177/15589447211014631

[5] Natural History of Pediatric Hand and Wrist Ganglion Cysts: Longitudinal Follow-Up of a Prospective, Dual-Center Cohort. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2023.07.002

[6] Arthroscopic resection of dorsal wrist ganglions with or without midcarpal exploration. Journal of Hand Surgery (European Volume). 2025. DOI: 10.1177/17531934251405730

[7] Cystic soft tissue tumours of the dorsal aspect of the wrist have two distinct histological subtypes. Journal of Hand Surgery (European Volume). 2024. DOI: 10.1177/17531934241251721

[8] Factors associated with self-reported pain and hand function following dorsal wrist ganglion excision. Journal of Hand Surgery (European Volume). 2023. DOI: 10.1177/17531934231153029

[9] Giant Cell Tumor of the Ring Finger Distal Phalanx. The Journal of Hand Surgery. 2021. DOI: 10.1016/j.jhsa.2020.04.005

[10] Giant Spindle Cell Lipoma of Middle Finger: Case Report and Review of Literature. Journal of Hand and Microsurgery. 2024. DOI: 10.1055/s-0040-1721879

[11] Persistent Median Artery With a Reversed Palmaris Longus and Volar Ganglion. Journal of Hand Surgery Global Online. 2022. DOI: 10.1016/j.jhsg.2022.04.005

[12] Large Angiolipoma of the Hand as a Cause for Carpal Tunnel Syndrome. Journal of Hand Surgery Global Online. 2022. DOI: 10.1016/j.jhsg.2022.05.006

[13] Parosteal Lipoma of the Proximal Phalanx of Hand. The Journal of Hand Surgery. 2021. DOI: 10.1016/j.jhsa.2020.10.029

[14] A Lange Medical Book Current Diagnosis Treatment In Orthopedics Fifth Edition. 9Hand Surgery > DIAGNOSIS OF DISORDERS OF THE HAND.

[15] Scar massage as an intervention for post-surgical scars: A practice survey of Australian hand therapists. Hand Therapy. 2023. DOI: 10.1177/17589983231205666

[16] What Are the Long-term Outcomes of Wrist Arthrodesis Using Structural Iliac Bone Graft After Resection of the Distal Radius for Giant Cell Tumor of Bone? A Minimum 10-year Follow-up. Clinical Orthopaedics & Related Research. 2025. DOI: 10.1097/corr.0000000000003738

[18] Green S Operative Hand Surgery. PROLIFERATIVE TENOSYNOVITIS > Rheumatoid Arthritis.

[20] Campbell S Operative Orthopaedics 4 Volume Set. THUMB CARPODNETACARPAL ARTHRODESIS WITH KIRSCHNER WIRE OR BLADE-PLATE FIXATION > SYNOVITIS OF THE WRIST.

[21] Green S Operative Hand Surgery. Indication for Wrist Surgery.

[29] No Difference in Reintervention at 1-Year Between Ultrasound-Guided versus Blind Dorsal Carpal Ganglion Aspiration. Journal of Hand Surgery Global Online. 2023. DOI: 10.1016/j.jhsg.2023.06.007

[30] Giant cell tumour of hand bones: outcomes of treatment. Journal of Hand Surgery (European Volume). 2021. DOI: 10.1177/17531934211007820

[33] Anatomical location of volar wrist ganglion in preoperative MRI is a risk factor for operation-related complications after arthroscopic ganglionectomy. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-08766-x

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Considerations for licensors: Our public licenses are intended for use by those authorized to give the public permission to use material in ways otherwise restricted by copyright and certain other rights. Our licenses are irrevocable. Licensors should read and understand the terms and conditions of the license they choose before applying it. Licensors should also secure all rights necessary before applying our licenses so that the public can reuse the material as expected. Licensors should clearly mark any material not subject to the license. This includes other CC- licensed material, or material used under an exception or limitation to copyright. More considerations for licensors: wiki.creativecommons.org/Considerations_for_licensors

Considerations for the public: By using one of our public licenses, a licensor grants the public permission to use the licensed material under specified terms and conditions. If the licensor's permission is not necessary for any reason--for example, because of any applicable exception or limitation to copyright--then that use is not regulated by the license. Our licenses grant only permissions under copyright and certain other rights that a licensor has authority to grant. Use of the licensed material may still be restricted for other reasons, including because others have copyright or other rights in the material. A licensor may make special requests, such as asking that all changes be marked or described. Although not required by our licenses, you are encouraged to respect those requests where reasonable. More considerations for the public: wiki.creativecommons.org/Considerations_for_licensees


Creative Commons Attribution-NonCommercial 4.0 International Public License

By exercising the Licensed Rights (defined below), You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution-NonCommercial 4.0 International Public License ("Public License"). To the extent this Public License may be interpreted as a contract, You are granted the Licensed Rights in consideration of Your acceptance of these terms and conditions, and the Licensor grants You such rights in consideration of benefits the Licensor receives from making the Licensed Material available under these terms and conditions.

Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.


Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.