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Wrist ganglion excision

Surgeon-side topic for wrist ganglion excision. Backed by 123 articles from the corpus, retrieved via combined MeSH + title-text matching.

Overview

Open surgical excision provides a significantly lower recurrence rate compared with aspiration, though surgical intervention itself carries an approximate 10% recurrence rate [2][12]. While most ganglions recur after aspiration, approximately 40% of wrist ganglion lesions decrease over the first 6 years following evaluation by a hand surgeon [12]. Surgical excision of primary wrist ganglia significantly reduces patient symptoms with low recurrence rates and high patient satisfaction [14]. Arthroscopic resection of dorsal wrist ganglion demonstrates favorable outcomes, recurrence, and complication rates over a minimum follow-up of 4 years [5].

Patient Counseling: Patients whose occupation or activities require forceful wrist extension should be counseled on the considerable risk of residual pain and functional limitations after open dorsal wrist ganglion excision [1]. Complication Risks: Operation-related complications after arthroscopic volar wrist ganglionectomy are associated with anatomical location distal to the bifurcation of the radial artery and concurrent penetration up to the superficial fascia layer [4]. Consequently, the practice of treating wrist ganglions with a sclerosant must be abandoned following catastrophic complications such as radial artery injury [3]. Pediatric Management: There is no consensus within the literature regarding the best management of pediatric wrist ganglia, and no single treatment modality confers a particular advantage or disadvantage over another [9], though a retrospective review reports a low recurrence rate of 5.3% for pediatric wrist ganglion cysts [11].

Adjunctive Considerations: Performing at least one aspiration before surgical excision improves the cost-effectiveness of dorsal wrist ganglion treatment when patient preferences preclude routinely performing two aspirations [7]. Quality of care would not be compromised by abandoning the practice of routinely submitting surgical specimens for pathological examination after excision of a clinically diagnosed wrist ganglion cyst [8]. Hand surgeons remain divided regarding the need to immobilize the wrist after dorsal wrist ganglion excision [10].

Anatomy & Pathophysiology

Pediatric wrist ganglions most commonly affect the dorsal aspect and demonstrate a female predilection [19]. These pediatric lesions exhibit a greater rate of spontaneous resolution compared to adult wrist ganglions [6]. Despite this, no consensus exists regarding the optimal management of pediatric wrist ganglia, and no single treatment modality confers a distinct advantage or disadvantage [9]. While the majority of wrist MRIs ordered at pediatric institutions are for pain [23], the literature does not definitively link wrist hyperlaxity to ganglion formation; an association exists, but causation is unproven [26, 35]. It remains possible that a single underlying pathological entity causes both conditions [35].

Cystic soft tissue tumours of the dorsal wrist comprise two distinct histological subtypes [20]. Open surgery is ineffective for these dorsal cysts due to high recurrence rates [20]. For volar ganglions, operation-related complications after arthroscopic excision are associated with anatomical locations distal to the bifurcation of the radial artery and those concurrently penetrated up to the superficial fascia layer [4].

Risk Factors for Recurrence: * Dominant side [15] * Female sex [15] * Age ≤24 years [15]

Treatment Considerations: * Arthroscopy is the primary treatment option for painful radiopalmar ganglions with a positive ulnocarpal stress test [25]. * Arthroscopy is also indicated for recurrent radiopalmar ganglions [25]. * Counseling is required for patients whose occupations or activities require forceful wrist extension, as they face a considerable risk of residual pain and functional limitations following open dorsal excision [1].

Classification

Management Modalities: Open surgical excision offers a significantly lower chance of recurrence compared with aspiration in the treatment of wrist ganglions [2], though most ganglions recur after aspiration [12]. Surgical intervention for wrist ganglions has approximately a 10% recurrence rate [12]. Open excision of dorsal wrist ganglia leads to a lower recurrence rate than arthroscopic excision [13]; however, advances in surgical techniques have allowed arthroscopic ganglion excision to achieve recurrence rates similar to those of open management [16]. Conversely, open surgery continues to be an ineffective way of managing cystic soft tissue tumours of the dorsal aspect of the wrist due to high recurrence rates [20]. The practice of treating wrist ganglions with a sclerosant must be abandoned following catastrophic complications such as radial artery injury [3].

Pediatric Considerations: Pediatric ganglions of the hand have a greater rate of resolution than ganglions of the wrist [6], while pediatric wrist ganglion cysts have a reported recurrence rate of 5.3% [11]. There is no consensus within the literature regarding the best management of pediatric wrist ganglia [9], and no single treatment modality for pediatric wrist ganglia confers a particular advantage or disadvantage over another [9]. Ganglions in pediatric populations most commonly affect the dorsal wrist [19] and demonstrate a female predilection [19].

Natural History and Outcomes: About 40% of wrist ganglion lesions decrease over the first 6 years after evaluation by a hand surgeon [12]. Patients whose occupation or activities require forceful wrist extension should be counseled on the considerable risk of residual pain and functional limitations after open dorsal wrist ganglion excision [1]. Operation-related complications after arthroscopic volar wrist ganglionectomy are associated with anatomical location distal to the bifurcation of the radial artery and concurrent penetration up to the superficial fascia layer [4]. Quality of care would not be compromised by abandoning the routine submission of surgical specimens for pathological examination after excision of a clinically diagnosed wrist ganglion cyst [8].

Clinical Presentation

Wrist ganglions present with variable natural histories depending on patient age and lesion location. Approximately 40% of wrist ganglion lesions decrease over the first 6 years after evaluation by a hand surgeon [12]. In pediatric populations, ganglions most commonly affect the dorsal wrist and demonstrate a female predilection [19], though in children aged less than 10 years, lesions mainly occur on the volar wrist and can be treated expectantly, with 69% to 79% displaying spontaneous regression within a span of 12 to 18 months [17]. If a cyst in a child ultimately resolves, it usually does so within 18 months [21]. Pediatric ganglions of the hand have a greater rate of resolution than ganglions of the wrist [6], and a retrospective review reports a low recurrence rate of 5.3% for pediatric wrist ganglion cysts [11].

Diagnostic and Management Considerations: Aspiration vs. Excision: Most ganglions recur after aspiration [12], whereas open surgical excision offers a significantly lower chance of recurrence compared with aspiration in the treatment of wrist ganglions [2]. Performing at least one aspiration before surgical excision improves the cost-effectiveness of dorsal wrist ganglion treatment when patient preferences preclude routinely performing two aspirations [7]. Sclerotherapy: The practice of treating wrist ganglions with a sclerosant must be abandoned following reports of catastrophic complications such as radial artery injury [3]. Pathology: Quality of care would not be compromised by abandoning the practice of routinely submitting surgical specimens for pathological examination after excision of a wrist ganglion cyst in patients with a clinical diagnosis [8]. Pediatric Management: There is no consensus within the literature regarding the best management of pediatric wrist ganglia, and no single treatment modality confers a particular advantage or disadvantage over another [9].

Surgical Outcomes and Complications: Surgical intervention for wrist ganglions has about a 10% recurrence rate, leaves scars, and carries some risk for adverse events [12]. Surgical excision of primary wrist ganglia significantly reduces patient symptoms with low recurrence rates and high patient satisfaction [14]. Approach Comparison: Open excision of dorsal wrist ganglia leads to a lower recurrence rate than arthroscopic excision [13], yet arthroscopy is supported as a treatment for dorsal wrist ganglion based on outcomes, recurrence, and complication rates after 4 years of follow-up [5]. Risk Factors: Dominant side, female sex, and age of 24 years or less are the most influential risk factors for recurrence after arthroscopic excision of dorsal wrist ganglia [15]. Patients whose occupation or activities require forceful wrist extension face a considerable risk of residual pain and functional limitations after open dorsal wrist ganglion excision [1]. Arthroscopic Complications: Operation-related complications after arthroscopic volar wrist ganglionectomy are associated with anatomical location distal to the bifurcation of the radial artery and concurrent penetration up to the superficial fascia layer [4]. Additionally, wrist arthroscopy is associated with a 1.24% incidence of ipsilateral wrist ganglion cyst formation, with female gender being a significant predictor of development [22].

Postoperative Care: Hand surgeons are divided regarding the need to immobilize the wrist after dorsal wrist ganglion excision [10].

Investigations

Aspiration: Open surgical excision offers a significantly lower chance of recurrence compared with aspiration in the treatment of wrist ganglions [2]. Performing at least one aspiration before surgical excision improves the cost-effectiveness of dorsal wrist ganglion treatment when patient preferences preclude routinely performing two aspirations [7]. The practice of treating wrist ganglions with a sclerosant must be abandoned following catastrophic complications such as radial artery injury [3].

Arthroscopy: Arthroscopy is supported as a treatment for dorsal wrist ganglion based on outcomes, recurrence, and complication rates after 4 years of follow-up [5]. Open excision of dorsal wrist ganglia leads to a lower recurrence rate than arthroscopic excision [13]. Dominant side, female sex, and age of 24 years or less are influential risk factors for recurrence after arthroscopic excision of dorsal wrist ganglia [15]. Wrist arthroscopy is associated with a 1.24% incidence of ipsilateral wrist ganglion cyst formation, with female gender being a significant predictor of development [22]. 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 [4]. Arthroscopy should be contemplated as the primary treatment option for patients with painful ganglions of the wrist if they are in a radiopalmar location with a positive ulnocarpal stress test and for patients with recurrent radiopalmar ganglions [25].

Pediatric Management: Pediatric ganglions of the hand have a greater rate of resolution than ganglions of the wrist [6]. In children aged less than 10 years, ganglions mainly occur on the volar wrist and can be treated expectantly, with 69% to 79% displaying spontaneous regression within 12 to 18 months [17]. In a child with a wrist ganglion, if the cyst ultimately resolved, it usually did so within 18 months [21]. A retrospective review reports a low recurrence rate of 5.3% for pediatric wrist ganglion cysts [11]. There is no consensus within the literature regarding the best management of pediatric wrist ganglia, and no single treatment modality confers a particular advantage or disadvantage over another [9].

Other Considerations: The majority of wrist MRIs ordered at a pediatric institution were for wrist pain [23]. A synovial fistula is a rare complication of recurrent dorsal wrist ganglion excision, potentially caused by extensive capsular excision and steroid injection [24]. Quality of care would not be compromised by abandoning the practice of routinely submitting surgical specimens for pathological examination after excision of the ganglion cyst in patients with a clinical diagnosis of wrist ganglion cyst [8]. Patients whose occupation or activities require forceful wrist extension should be counseled on the considerable risk of residual pain and functional limitations that may occur after open dorsal wrist ganglion excision [1]. A case report demonstrates the efficacy of interventional radiological measures rather than open surgery for treating a volar wrist ganglion presenting as trigger finger [18].

Treatment

Non-Operative

Approximately 40% of wrist ganglion lesions decrease over the first 6 years after evaluation by a hand surgeon [12]. Most ganglions recur after aspiration [12]. Performing at least one aspiration before surgical excision improves the cost-effectiveness of dorsal wrist ganglion treatment when patient preferences preclude routinely performing two aspirations [7]. The practice of treating wrist ganglions with a sclerosant must be abandoned following reports of catastrophic complications such as radial artery injury [3].

Operative

Indications: Surgical intervention is considered when conservative measures fail or when specific risk factors are present. Patients whose occupation or activities require forceful wrist extension should be counseled on the considerable risk of residual pain and functional limitations after open dorsal wrist ganglion excision [1]. Dominant side, female sex, and age of 24 years or less are considered the most influential risk factors for recurrence after arthroscopic excision of dorsal wrist ganglia [15].

Surgical Approach / Technique: Open surgical excision offers a significantly lower chance of recurrence compared with aspiration in the treatment of wrist ganglions [2]. Open excision of dorsal wrist ganglia leads to a lower recurrence rate than arthroscopic excision [13]. Advances in surgical techniques have allowed surgeons to conduct arthroscopic ganglion excision with recurrence rates similar to those of open management [16]. Operation-related complications after arthroscopic volar wrist ganglionectomy are associated with anatomical location distal to the bifurcation of the radial artery and concurrent penetration up to the superficial fascia layer [4]. A volar wrist ganglion presenting as trigger finger can be treated with interventional radiological measures rather than open surgery, demonstrating the efficacy of this technique [18].

Implant Selection: Not applicable.

Alignment / Balancing Strategy: Not applicable.

Pain Management: Not applicable.

Adjuncts: Quality of care would not be compromised by abandoning the practice of routinely submitting surgical specimens for pathological examination after excision of a wrist ganglion cyst in patients with a clinical diagnosis [8]. Hand surgeons are divided regarding the need to immobilize the wrist after dorsal wrist ganglion excision [10].

Setting of Care: Outcomes, recurrence, and complication rates after 4 years of follow-up support the use of arthroscopy as a treatment for dorsal wrist ganglion [5]. Surgical excision of primary wrist ganglia significantly reduces patient symptoms with low recurrence rates and high patient satisfaction [14].

Revision: A synovial fistula is a rare complication of recurrent dorsal wrist ganglion excision, potentially caused by extensive capsular excision and steroid injection [24].

Other Considerations: Pediatric ganglions of the hand have a greater rate of resolution than ganglions of the wrist [6]. There is no consensus within the literature regarding the best management of pediatric wrist ganglia, and no single treatment modality confers a particular advantage or disadvantage over another [9]. A retrospective review reports a low recurrence rate of 5.3% for pediatric wrist ganglion cysts [11]. Surgical intervention for wrist ganglions has about a 10% recurrence rate, leaves scars, and carries some risk for adverse events [12].

Complications

Recurrence: Open surgical excision offers a significantly lower chance of recurrence compared with aspiration [2], though open excision of dorsal wrist ganglia leads to a lower recurrence rate than arthroscopic excision [13]. Conversely, advances in surgical techniques have allowed surgeons to conduct arthroscopic ganglion excision with recurrence rates similar to those of open management [16], and at 12 months follow-up, the rates of recurrence with arthroscopic dorsal ganglion excision are comparable with and not superior to those of open excision [27]. However, open surgery continues to be an ineffective way of managing cystic soft tissue tumors of the dorsal aspect of the wrist due to high recurrence rates [20]. Risk factors for recurrence after arthroscopic excision of dorsal wrist ganglia include dominant side, female sex, and age of 24 years or less [15]. Pediatric wrist ganglion cysts have a reported low recurrence rate of 5.3% [11].

Nerve Injury: Operation-related complications after arthroscopic volar wrist ganglionectomy are associated with anatomical location distal to the bifurcation of the radial artery and concurrent penetration up to the superficial fascia layer [4]. The practice of treating wrist ganglions with a sclerosant must be abandoned due to the risk of catastrophic complications such as radial artery injury [3]. Excision of the articular nerve branch is advised to avoid recurrences in cases of a ganglion within the ulnar nerve communicating with the distal radioulnar joint via an articular branch [36].

Functional Limitations and Stiffness: Patients whose occupation or activities require forceful wrist extension face a considerable risk of residual pain and functional limitations after open dorsal wrist ganglion excision [1]. Hand surgeons are divided regarding the need to immobilize the wrist after dorsal wrist ganglion excision [10]. Patients experienced significant increases in function and decreases in pain within 6 weeks after arthroscopic ganglion cyst resection, with recurrence and complication rates appearing comparable to open resections [28].

Other Considerations: Surgical intervention for wrist ganglions leaves scars and carries some risk for adverse events [12]. Surgical excision of primary wrist ganglia significantly reduces patient symptoms with low recurrence rates and high patient satisfaction [14]. Arthroscopic resection of dorsal wrist ganglion is supported by outcomes, recurrence, and complication rates over a minimum follow-up of 4 years [5]. Performing at least one aspiration before surgical excision improves the cost-effectiveness of dorsal wrist ganglion treatment when patient preferences preclude routinely performing two aspirations [7]. Pediatric ganglions of the hand have a greater rate of resolution than ganglions of the wrist [6]. In children aged less than 10 years, ganglions mainly occur on the volar wrist and can be treated expectantly, with 69% to 79% displaying spontaneous regression within 12 to 18 months [17]. Patients with wrist hyperlaxity have a predisposition to developing ganglions [26].

Recovery

Light activity (weeks): Patients typically experience significant increases in function and decreases in pain within 6 weeks after arthroscopic ganglion cyst resection [28]. While hand surgeons remain divided regarding the need for postoperative wrist immobilization after dorsal wrist ganglion excision [10], most patients can resume desk work, driving, and light activities of daily living within this 6-week window provided they avoid forceful wrist extension.

Full activity (months): Outcomes, recurrence, and complication rates after 4 years of follow-up support the use of arthroscopy as a treatment for dorsal wrist ganglion [5], with recurrence and complication rates appearing comparable to open resections [28]. However, patients whose occupation or activities require forceful wrist extension face a considerable risk of residual pain and functional limitations after open dorsal wrist ganglion excision [1]. Surgical intervention for wrist ganglions leaves scars and carries some risk for adverse events [12], though surgical excision of primary wrist ganglia significantly reduces patient symptoms with low recurrence rates and high patient satisfaction [14].

Complete recovery / outcome plateau (months): About 40% of wrist ganglion lesions decrease over the first 6 years after evaluation by a hand surgeon [12]. In children aged less than 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 to 18 months [17]. For cases involving nerve compression, subsequent excision of a ganglionic cyst causing suprascapular nerve denervation and external neurolysis resulted in complete return of nerve function, muscle bulk, and strength [29].

Rehabilitation protocol: The practice of treating wrist ganglions with a sclerosant must be abandoned due to the risk of catastrophic complications such as radial artery injury [3]. Open surgical excision offers a significantly lower chance of recurrence compared with aspiration in the treatment of wrist ganglions [2], and performing at least one aspiration before surgical excision improves the cost-effectiveness of dorsal wrist ganglion treatment when patient preferences preclude routinely performing two aspirations [7]. Regarding surgical technique, open excision of dorsal wrist ganglia leads to a lower recurrence rate than does arthroscopic excision [13], though advances in surgical techniques have allowed surgeons to conduct arthroscopic ganglion excision with recurrence rates similar to those of open management [16]. At 12 months follow-up, the rates of recurrence with arthroscopic dorsal ganglion excision are comparable with and not superior to those of open excision [27]. Most ganglions recur after aspiration [12], whereas surgical intervention for wrist ganglions has about a 10% recurrence rate [12].

Functional milestones: Quality of care would not be compromised by abandoning the practice of routinely submitting surgical specimens for pathological examination after excision of a wrist ganglion cyst in patients with a clinical diagnosis [8].

Other Considerations: Surgical intervention for wrist ganglions has about a 10% recurrence rate [12]. Most ganglions recur after aspiration [12]. Open surgical excision offers a significantly lower chance of recurrence compared with aspiration in the treatment of wrist ganglions [2]. Patients whose occupation or activities require forceful wrist extension face a considerable risk of residual pain and functional limitations after open dorsal wrist ganglion excision [1].

Key Evidence

  • [L4] Patients whose occupation or activities require forceful wrist extension should be counseled on the considerable risk of residual pain and functional limitations that may occur after open dorsal wrist ganglion excision. (10.1016/j.jhsa.2015.05.030)
  • [L1] Open surgical excision offers significantly lower chance of recurrence compared with aspiration in the treatment of wrist ganglions. (10.1016/j.jhsa.2014.12.014)
  • [L4] After this catastrophic complication of the treatment of a benign condition, the practice of treating wrist ganglions with a sclerosant must be abandoned. (10.1177/1753193409105561)
  • [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. (10.1186/s12891-025-08766-x)
  • [L4] The outcomes, recurrence, and complications rates after 4 years of follow-up presented in this study support the use of arthroscopy as a treatment for dorsal wrist ganglion. (10.1177/1558944717743601)
  • [L4] Pediatric ganglions of the hand have a greater rate of resolution than ganglions of the wrist. (10.1016/j.jhsa.2023.07.002)
  • [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. (10.1016/j.jhsa.2022.09.002)
  • [L3] This study suggests that, in patients with the clinical diagnosis of wrist ganglion cyst, quality of care would not be compromised by abandoning the practice of routinely submitting surgical specimens for pathological examination after excision of the ganglion cyst. (10.1016/j.jhsa.2010.03.021)
  • [L4] There is no consensus within the literature regarding the best management of pediatric wrist ganglia, and no single treatment modality confers a particular advantage or disadvantage over another. (10.1177/1558944720966716)
  • [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. (10.1177/15589447211014631)
  • [L4] This retrospective review reports a low recurrence rate of 5.3% for pediatric wrist ganglion cysts, indicating potential merit in the surgeon's operative and postoperative techniques. (10.1177/1558944717751195)
  • [L5] Current best evidence suggests that about 40% of lesions decrease over the first 6 years after evaluation by a hand surgeon, that most ganglions recur after aspiration, and that surgical intervention has about a 10% recurrence rate, leaves scars, and has some risk for adverse events. (10.1016/j.jhsa.2010.11.048)
  • [L3] This study suggests that open excision of dorsal wrist ganglia leads to a lower recurrence rate than does arthroscopic excision. (10.1177/15589447211003184)
  • [L4] Surgical excision of primary wrist ganglia significantly reduces patient symptoms with low recurrence rates and high patient satisfaction. (10.1177/1753193411434376)
  • [L4] Dominant side, female sex, and age of 24 years or less are considered to be the most influential risk factors for recurrence after arthroscopic excision of dorsal wrist ganglia. (10.1016/j.arthro.2013.04.002)
  • [L4] Advances in surgical techniques have allowed surgeons to conduct arthroscopic ganglion excision with recurrence rates similar to those of open management. (10.5435/jaaos-d-22-00105)
  • [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. (10.1016/j.jhsa.2021.12.015)
  • [L4] This is the first reported case of triggering pathology at the wrist to be treated with interventional radiological measures rather than open surgery and demonstrates the efficacy of the technique. (10.1177/1753193412453699)
  • [L2] Ganglions in pediatric populations, which most commonly affect the dorsal wrist, demonstrate a female predilection. (10.1016/j.jhsa.2021.02.026)
  • [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. (10.1177/17531934241251721)
  • [L4] In a child with a wrist ganglion, if the cyst ultimately resolved, it usually did so within 18 months. (10.1016/j.jhsa.2019.10.032)
  • [L3] Wrist arthroscopy is associated with a 1.24% incidence of ipsilateral wrist ganglion cyst formation, with female gender being a significant predictor of development. (10.1177/1558944720939203)
  • [L4] At our pediatric institution, the majority of wrist MRIs were ordered for wrist pain. (10.1177/1558944717695752)
  • [Case_report] A synovial fistula is a rare complication of recurrent dorsal wrist ganglion excision, potentially caused by extensive capsular excision and steroid injection. (10.1016/j.jhsa.2012.02.015)
  • [L4] Therefore, arthroscopy should be contemplated as the primary treatment option for patients with painful ganglions of the wrist if they are in a radiopalmar location with a positive ulnocarpal stress test and for patients with recurrent radiopalmar ganglions. (10.1016/j.jhsa.2012.04.042)
  • [L3] Patients with wrist hyperlaxity have a predisposition to developing ganglions, a finding corroborated by independent investigations using similar prospective cohort designs. (10.1016/j.jhsa.2013.11.025)
  • [L1] At 12 months follow-up, the rates of recurrence with arthroscopic dorsal ganglion excision are comparable with and not superior to those of open excision. (10.1016/j.jhsa.2008.01.009)
  • [L4] Patients experienced significant increases in function and decreases in pain within 6 weeks after arthroscopic ganglion cyst resection, and the recurrence and complication rates appear to be comparable to open resections. (10.1016/j.jhsa.2008.11.025)
  • [L4] Subsequent excision of the ganglion and external neurolysis resulted in complete return of nerve function, muscle bulk, and strength. (10.2106/00004623-198668040-00025)
  • [L3] Although an association between wrist ganglions and ligamentous hyperlaxity does not prove causation, the possibility of the same underlying pathological entity causing both can be envisioned. (10.1016/j.jhsa.2013.08.109)
  • [Case_report] Excision of the articular nerve branch is advised to avoid recurrences. (10.1016/j.jhsa.2011.08.008)

See Also

References

[1] Outcomes of Open Dorsal Wrist Ganglion Excision in Active-Duty Military Personnel. The Journal of Hand Surgery. 2015. DOI: 10.1016/j.jhsa.2015.05.030

[2] Wrist Ganglion Treatment: Systematic Review and Meta-Analysis. The Journal of Hand Surgery. 2015. DOI: 10.1016/j.jhsa.2014.12.014

[3] Radial artery injury caused by a sclerosant injected into a palmar wrist ganglion. Journal of Hand Surgery (European Volume). 2009. DOI: 10.1177/1753193409105561

[4] 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

[5] Arthroscopic Resection of Dorsal Wrist Ganglion: Results and Rate of Recurrence Over a Minimum Follow-up of 4 Years. HAND. 2017. DOI: 10.1177/1558944717743601

[6] 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

[7] 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

[8] Necessity of Routine Pathological Examination After Surgical Excision of Wrist Ganglions. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2010.03.021

[9] Wrist Ganglion Cysts in Children: An Update and Review of the Literature. HAND. 2020. DOI: 10.1177/1558944720966716

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

[11] Pediatric Ganglion Cysts: A Retrospective Review. HAND. 2018. DOI: 10.1177/1558944717751195

[12] Wrist Ganglions. The Journal of Hand Surgery. 2011. DOI: 10.1016/j.jhsa.2010.11.048

[13] Recurrence Rates of Dorsal Wrist Ganglion Cysts After Arthroscopic Versus Open Surgical Excision: A Retrospective Comparison. HAND. 2021. DOI: 10.1177/15589447211003184

[14] Patient outcomes following wrist ganglion excision surgery. Journal of Hand Surgery (European Volume). 2012. DOI: 10.1177/1753193411434376

[15] Arthroscopic Excision of Dorsal Wrist Ganglion: Factors Related to Recurrence and Postoperative Residual Pain. Arthroscopy. 2013. DOI: 10.1016/j.arthro.2013.04.002

[16] Ganglions in the Hand and Wrist: Advances in 2 Decades. Journal of the American Academy of Orthopaedic Surgeons. 2023. DOI: 10.5435/jaaos-d-22-00105

[17] 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

[18] Volar wrist ganglion presenting as trigger finger. Journal of Hand Surgery (European Volume). 2012. DOI: 10.1177/1753193412453699

[19] Clinical Presentation and Characteristics of Hand and Wrist Ganglion Cysts in Children. The Journal of Hand Surgery. 2021. DOI: 10.1016/j.jhsa.2021.02.026

[20] 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

[21] Wrist Ganglia in Children: Nonsurgical Versus Surgical Treatment. The Journal of Hand Surgery. 2020. DOI: 10.1016/j.jhsa.2019.10.032

[22] Prevalence of Ganglion Cyst Formation After Wrist Arthroscopy: A Retrospective Longitudinal Analysis of 2420 Patients. HAND. 2020. DOI: 10.1177/1558944720939203

[23] The Diagnostic Utility and Clinical Implications of Wrist MRI in the Pediatric Population. HAND. 2017. DOI: 10.1177/1558944717695752

[24] Synovial Fistula as a Complication of Recurrent Dorsal Wrist Ganglion Excision: Case Report. The Journal of Hand Surgery. 2012. DOI: 10.1016/j.jhsa.2012.02.015

[25] Ganglions of the Wrist and Associated Triangular Fibrocartilage Lesions: A Prospective Study in Arthroscopically-treated Patients. The Journal of Hand Surgery. 2012. DOI: 10.1016/j.jhsa.2012.04.042

[26] Increased Prevalence of Ganglion Formation Among Patients With Wrist Hyperlaxity. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2013.11.025

[27] Arthroscopic Versus Open Dorsal Ganglion Excision: A Prospective, Randomized Comparison of Rates of Recurrence and of Residual Pain. The Journal of Hand Surgery. 2008. DOI: 10.1016/j.jhsa.2008.01.009

[28] Prospective Outcomes and Associations of Wrist Ganglion Cysts Resected Arthroscopically. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2008.11.025

[29] Suprascapular nerve denervation secondary to attenuation by a ganglionic cyst.. The Journal of Bone & Joint Surgery. 1986. DOI: 10.2106/00004623-198668040-00025

[35] Ligamentous Hyperlaxity and Dorsal Wrist Ganglions. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2013.08.109

[36] A Ganglion Within the Ulnar Nerve and Communication With the Distal Radioulnar Joint via an Articular Branch: Case Report. The Journal of Hand Surgery. 2011. DOI: 10.1016/j.jhsa.2011.08.008

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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.