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屈肌腱鞘囊肿

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A benign, fluid-filled cyst arising from the flexor tendon sheath – often painless, but can cause clicking or limited finger movement.

Updated Aug 2026
一幅手绘插图，显示手指基部有一个小而硬的肿块。
屈肌腱鞘囊肿：位于手指基部的一个小而硬的囊肿。 Kieran Hirpara 4.0

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

您的感受

您可能会在手腕或手上发现一个柔软的肿块。它通常感觉像皮肤下有一个小水气球。肿块可能会突然出现，也可能随时间缓慢增大。许多人感到该区域有紧绷感或酸痛感。疼痛通常较轻，但在以特定方式活动手腕时可能会变得尖锐。当您向后弯曲手腕或紧紧抓握物体时，可能会感到不适。

由于肿块或疼痛，日常任务可能会变得困难。伸手到背后扣文胸可能会感到别扭。将衬衫塞进裤子里时，可能会牵拉囊肿上方的皮肤。提起重物或打开罐子可能会加重该区域的不适。如果肿块压迫到附近的神经，有些人会感到刺痛。这可能会让您的手感到无力或麻木。在重复性手腕活动或剧烈活动后，症状往往会加重。

疼痛可能在夜间发作，使人难以舒适地入睡。您可能会发现很难将手腕枕在枕头上。醒来时，僵硬感可能会更加明显。然而，肿块本身并不总是会引起疼痛。在某些情况下，它只是一个在外观上让您困扰的可见隆起。大约 40% 的腕部腱鞘囊肿在未经治疗的前 6 年内会缩小。这意味着随着时间的推移，您的症状可能会自行改善。

如果肿块变大，可能会限制您的活动范围。您可能会注意到手腕的弯曲不如以前顺畅。不适感可能会干扰需要精细运动技能的工作或爱好。由于担心引起更多疼痛，您可能会避免使用您的手。倾听身体的声音并在该区域感到酸痛时休息非常重要。您的外科医生将帮助您了解症状是由腱鞘囊肿还是其他问题引起的。

实际发生了什么

腱鞘囊肿是一种形成于关节或肌腱附近的充满液体的囊袋。可以将其想象为一个从关节滑膜层发育而来的小水球。这层被称为滑膜的衬里会产生润滑液，以帮助关节顺畅活动。有时，这些液体会从关节囊的薄弱处渗出或突出。关节囊是包裹在关节周围的坚韧套筒。

液体在囊袋中积聚，形成您可以看到或摸到的肿块。这个肿块可能会压迫附近的结构。例如，它可能会压迫神经，导致疼痛或无力。它还可能阻碍肌腱的活动，肌腱是连接肌肉与骨骼的强韧索状组织。这种压力就是您可能会感到不适或注意到活动受限的原因。

在某些情况下，囊肿与关节腔直接相通。这意味着液体可以在关节和囊肿之间来回流动。这种连通性解释了为什么肿块可能会改变大小或暂时消失。身体有时会自动重新吸收这些液体。在由手外科医生评估后的前 6 年中，约 40% 的腕部腱鞘囊肿病变会缩小。

然而，如果囊肿持续存在，可能会引起持续的问题。它可能导致扳机指（弹响指），即肌腱在活动时发生卡顿。或者它可能会压迫神经，导致麻木或刺痛。您的外科医生将对患处进行检查以确诊。他们可能会使用影像学检查来观察囊肿的位置和大小。

治疗取决于您的症状。有些人选择观察，看其是否自行改善。其他人则倾向于积极治疗。由于成本低、无需恢复期且复发率低，经皮穿刺是处理屈肌腱鞘腱鞘囊肿的实用选择。这涉及用针头引流液体。如果囊肿复发，手术切除将完全移除囊袋。与抽吸术相比，开放性手术切除在治疗腕部腱鞘囊肿时显著降低了复发几率。

我们的目标是缓解您的症状并恢复正常功能。您的外科医生将讨论针对您具体病例的最佳方案。目标是减轻疼痛并提高您使用手和腕部的能力。

我们能采取的措施

针对屈肌腱鞘囊肿的处理方式，通常取决于其对您的困扰程度以及存在的时间长短。Mater Private Hospital Rockhampton 的上肢外科医生 Kieran Hirpara 博士会在我们的诊所中，根据您的具体症状和生活方式来指导这一决策。我们首先会了解您在无痛状态下能够进行哪些活动。许多囊肿会自行缩小。据观察，约 40% 的腕部囊肿病变在经手外科医生评估后的前 6 年内体积会减小。在儿童中，如果囊肿自行消退，通常会在 18 个月内发生。

您可以先尝试简单的自我护理。这包括改变活动方式，以避免对肌腱造成重复性劳损。您的物理治疗师或手治疗师可以教您温和的练习，以保持关节活动顺畅。夹板固定可能有助于休息该区域并减少刺激。我们通常建议在考虑更侵入性的步骤之前，先充分尝试这种非手术治疗。如果囊肿未引起疼痛或限制您的活动，观察等待是一个安全且有效的选择。

如果症状持续存在，我们将转向药物治疗。这通常涉及使用止痛药和抗炎药物来管理不适。我们也可能提供注射治疗。皮质类固醇注射可以减少肿胀和疼痛，尽管效果是暂时的。透明质酸或富血小板血浆（PRP）注射有时用于支持组织健康，但其长期疗效因人而异。穿刺抽吸（用针头排出液体）是处理屈肌腱鞘囊肿的一种实用选择。它具有成本低、无需恢复期以及复发率低的特点。在一些研究中，第二次穿刺后未观察到复发。然而，大多数囊肿在单次抽吸后会复发。我们将穿刺抽吸视为有症状病例的一线干预措施。

当保守治疗未能带来足够改善，或囊肿引起明显的神经压迫时，会考虑手术治疗。手术切除对于这些有症状的病例仍然是一种有效的选择。与穿刺抽吸相比，开放手术切除显著降低了复发几率。对于腕部囊肿，手术干预的复发率约为 10%。我们会讨论诸如疤痕或不良事件等风险，并将其与切除囊肿的益处进行权衡。在某些情况下，关节镜技术允许我们同时治疗囊肿和任何其他潜在的关节问题。我们共同做出这一决定，确保您了解预期的结果和康复过程。

预期情况

您的腱鞘囊肿是一种充满液体的肿块，其行为往往难以预测。在就诊手外科医生后的前6年内，约40%的手腕腱鞘囊肿体积会缩小。许多人发现肿块时隐时现，或在多年内保持大小不变。如果不予处理，它可能会自行缩小，但也可能持续存在或增大。

如果您选择不治疗，可能会长期携带该肿块。有些人完全无痛，而另一些人则感到僵硬或轻微不适。如果肿块压迫邻近结构，您可能会注意到无力或感觉改变。在许多情况下，身体会自然吸收液体，但这并非必然发生。

如果您决定切除肿块，您的外科医生将讨论针对您具体病例的最佳治疗方案。穿刺抽吸（用针头引流液体）是常见的初步步骤。然而，大多数腱鞘囊肿在抽吸后会复发。与抽吸相比，手术切除复发的可能性显著降低。对于手腕腱鞘囊肿，手术干预的复发率约为10%。这意味着在大约90%的病例中，肿块不会复发。

术后恢复涉及肿胀和疼痛的管理。大多数患者在关节镜下腱鞘囊肿切除术后6周内，功能显著改善，疼痛明显减轻。开放切除会留下疤痕，并伴随一定的不良事件风险。关节镜技术允许同时处理其他问题，且复发率通常与开放手术相当。

您的外科医生将帮助您权衡风险与获益。他们会考虑您的年龄、活动水平以及肿块对您的困扰程度。没有一种适合所有人的最佳治疗方案。有些人倾向于观察等待，而另一些人则倾向于彻底切除以避免未来的不确定性。您的外科医生将引导您选择最适合您生活目标和需求的治疗方案。

何时就诊

如果您发现手腕或手部出现肿块，并伴有持续性疼痛、无力或不稳，请咨询您的全科医生（GP）。如果肿胀导致关节锁定、打软腿，或影响睡眠或工作，请寻求专科医生评估。症状突然加重也需要进行评估。虽然许多腱鞘囊肿在六年内会缩小，但有些需要干预。经皮穿刺对屈肌腱鞘腱鞘囊肿的复发率较低，在一项研究中，第二次穿刺后未观察到复发。然而，大多数腱鞘囊肿在简单抽吸后会复发。您的外科医生可以帮助您决定是否需要进一步治疗以恢复功能和舒适度。

Reviewed by Dr Kieran Hirpara · 10 June 2026.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

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

  • Surgical excision is a simple, safe, and effective method for treating a painful ganglion of the digital flexor tendon sheath [1].
  • Percutaneous puncture is a practical option for managing flexor tendon sheath ganglions due to its low cost, lack of downtime, and low recurrence rate [2].
  • No recurrences were observed after a second percutaneous puncture in the assessed cohort [2].
  • Pediatric ganglions are more commonly found on the volar surface of the hand and wrist compared to adults [3].
  • Pediatric ganglions more commonly have a tendon sheath origin compared to adult ganglions [3].
  • There is no consensus within the literature regarding the best management of pediatric wrist ganglia [5].
  • No single treatment modality confers a particular advantage or disadvantage over another for pediatric wrist ganglia [5].
  • Endoscopic ganglionectomy via flexor carpi radialis tendoscopy is a minimally invasive approach that offers better cosmesis [4].
  • Endoscopic ganglionectomy via flexor carpi radialis tendoscopy results in less soft tissue trauma [4].
  • Endoscopic ganglionectomy via flexor carpi radialis tendoscopy allows for the management of concomitant FCR tendon pathology [4].
  • Endoscopic ganglionectomy via flexor carpi radialis tendoscopy carries risks of recurrence and nerve or vessel injury [4].
  • Arthroscopy allows for the simultaneous treatment of ganglions and other pathologies [8].
  • Outcomes, recurrence, and complications rates after 4 years of follow-up support the use of arthroscopy as a treatment for dorsal wrist ganglion [9].
  • The quality of care would not be compromised by abandoning the practice of routine submission of surgical specimens for pathological examination after excision of a wrist ganglion cyst [10].
  • Routinely performing wrist radiography is not cost-effective in the evaluation and treatment decision-making process for patients with a wrist ganglion [12].
  • Routine wrist radiography is not useful in the evaluation of patients with a ganglion cyst of the wrist due to a low prevalence of therapeutically significant findings [12].
  • At 12 months follow-up, the rates of recurrence with arthroscopic dorsal ganglion excision are comparable with those of open excision [13].
  • At 12 months follow-up, the rates of recurrence with arthroscopic dorsal ganglion excision are not superior to those of open excision [13].
  • About 40% of wrist ganglion lesions decrease over the first 6 years after evaluation by a hand surgeon [14].
  • Most ganglions recur after aspiration [14].
  • Surgical intervention for wrist ganglions has about a 10% recurrence rate [14].
  • Surgical intervention for wrist ganglions leaves scars [14].
  • Surgical intervention for wrist ganglions has some risk for adverse events [14].
  • Operation-related complications after arthroscopic volar wrist ganglionectomy are associated with the anatomical location of the ganglion [18].
  • Operation-related complications after arthroscopic volar wrist ganglionectomy are associated with the ganglion being distal to the bifurcation of the radial artery [18].
  • Operation-related complications after arthroscopic volar wrist ganglionectomy are associated with the ganglion concurrently penetrating up to the superficial fascia layer [18].

Anatomy & Pathophysiology

  • Patients with wrist hyperlaxity have a predisposition to developing ganglions [53].
  • The incidence of dorsal wrist ganglia is higher in the military population compared with the civilian population [28].
  • Surgical recurrence rates for ganglion cysts range from 4% to 40% [27].
  • Complications of ganglion cyst surgery include infection, nerve injury, and wrist stiffness [27].
  • Dominant side, female sex, and age of 24 years or less are influential risk factors for recurrence after arthroscopic excision of dorsal wrist ganglia [55].
  • Worse hand function is associated with recurrence following prior surgery [31].
  • Worse hand function is associated with worse baseline hand function [31].
  • Worse hand function is associated with lower treatment credibility [31].
  • Intraneural ganglions require identification and excision of the articular branch of the involved nerve [30].
  • Arthroscopic treatment of intraosseous ganglion cysts of the lunate bone results in cyst resorption with fewer complications such as joint stiffness and vascular disturbances [45].

Classification

  • Pediatric ganglions more commonly have a tendon sheath origin compared to adults [3].
  • Ganglions in pediatric populations most commonly affect the dorsal wrist [20].
  • Ganglions in pediatric populations demonstrate a female predilection [20].
  • Women are significantly more likely to be diagnosed with a volar wrist ganglion, regardless of age or military status [7].
  • The incidence of dorsal wrist ganglia is higher in the military compared with the civilian population [28].
  • Tendon-associated ganglion cysts are not usual, although flexor hallucis longus tendinopathy is common in athletes [6].
  • Type A ganglion cysts of the radiocapitellar joint may involve compression of the superficial radial nerve [50].

Clinical Presentation

  • Pediatric ganglions more commonly have a tendon sheath origin compared to those in adults [3].
  • In children aged <10 years, ganglions mainly occur on the volar wrist [17].
  • Pediatric ganglions of the hand have a greater rate of resolution than ganglions of the wrist [15].
  • In a child with a wrist ganglion, if the cyst ultimately resolved, it usually did so within 18 months [11].
  • In children aged <10 years, 69% to 79% of volar wrist ganglions display spontaneous regression within a span of 12-18 months [17].
  • MRI is an excellent diagnostic modality to evaluate rapidly growing upper extremity masses and distinguish ganglions from malignant processes [16].
  • MRI scans provide relatively good reliability in establishing the diagnosis of an occult dorsal wrist ganglion, with a sensitivity of 83% when using intra-operative findings as the standard [21].
  • Advanced imaging has value in patients presenting with an atraumatic, painful, and progressive elbow contracture [24].
  • Intraneural ganglions should be considered in the differential diagnosis of a mass in the vicinity of a nerve [22].
  • Uncommon aetiologies should be considered in patients with atypical symptoms of carpal tunnel syndrome [32].

Investigations

  • Routine submission of surgical specimens for pathological examination after excision of a clinically diagnosed wrist ganglion cyst does not compromise quality of care [10].
  • Routinely performing wrist radiography is not cost-effective in the evaluation and treatment decision-making process for patients with a wrist ganglion due to a low prevalence of therapeutically significant findings [12].
  • Radiologists are less likely to identify occult dorsal ganglion cysts on MRI if the cyst is smaller or if the requisition form does not mention a cyst [41].
  • Preoperative MRI is essential for the diagnosis of intra-articular ganglion cysts of the cruciate ligaments [42].
  • Ganglion cysts of the cruciate ligaments can easily be detected by MRI [43].
  • Sonography-guided wrist arthroscopy provides visualization of the ganglions and ganglion stalk, as well as of the arthroscopic shaver and adjacent structures such as nerves, vessels, and tendons to perform surgery safely [36].
  • Sonography-assisted arthroscopic resection is a safer and more reliable method for treating volar wrist ganglia [23].

Treatment

Non-Operative Management

  • Nonsurgical treatment is largely ineffective in treating ganglion cysts [37].
  • Nonsurgical treatment may be considered for symptomatic relief in patients who do not want surgery [37].
  • Ganglion aspiration should be considered as a first-line intervention [40].
  • Percutaneous puncture is a practical option for managing flexor tendon sheath ganglions given its low cost, lack of downtime, and low recurrence rate [2].
  • No recurrences were observed after a second puncture in the cohort studied for percutaneous puncture of flexor sheath ganglions [2].

Operative Management: General Outcomes

  • Surgical intervention has about a 10% recurrence rate [14].
  • Surgical intervention leaves scars and has some risk for adverse events [14].
  • Surgical recurrence rates range from 4% to 40% [27].
  • Complications of surgical treatment include infection, nerve injury, and wrist stiffness [27].
  • Open surgical excision offers a significantly lower chance of recurrence compared with aspiration in the treatment of wrist ganglions [39].
  • Surgical excision remains an effective option for symptomatic cases where aspiration is not suitable or has failed [40].

Operative Management: Arthroscopic Techniques

  • Arthroscopic resection is an effective treatment strategy for intra-articular synovial ganglions refractory to conservative measures, providing complete resolution of symptoms and functional recovery with minimal soft tissue damage [34].
  • Arthroscopic ganglionectomy through an intrafocal cystic portal is a safe and efficacious option for the treatment of painful wrist ganglia [35].
  • Arthroscopic debridement of ganglion cysts offers excellent outcomes without recurrence [38].
  • Ganglion cysts have a high association with certain interosseous laxities [19].
  • Recurrent ganglion cysts originating from the midcarpal joint are not contraindications for arthroscopic resection [19].
  • The outcomes, recurrence, and complications rates after 4 years of follow-up support the use of arthroscopy as a treatment for dorsal wrist ganglion [9].
  • 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 [13].

Operative Management: Endoscopic Techniques

  • Endoscopic ganglionectomy via flexor carpi radialis tendoscopy offers less soft tissue trauma [4].
  • Endoscopic ganglionectomy via flexor carpi radialis tendoscopy allows for the ability to manage concomitant FCR tendon pathology [4].

Pathological Examination

  • In patients with the clinical diagnosis of wrist ganglion cyst, the quality of care would not be compromised by abandoning the practice of routine submission of surgical specimens for pathological examination after excision of the ganglion cyst [10].
  • In patients with the clinical diagnosis of wrist ganglion cyst, the 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 [25].

Complications

  • Surgical excision of digital flexor tendon sheath ganglions is considered a safe method [1].
  • Percutaneous puncture of flexor tendon sheath ganglions is associated with a low recurrence rate [2].
  • Surgical intervention for wrist ganglions has approximately a 10% recurrence rate [14].
  • Surgical intervention for wrist ganglions carries some risk for adverse events [14].
  • Operation-related complications after arthroscopic volar wrist ganglionectomy are associated with the cyst's anatomical location distal to the bifurcation of the radial artery and penetration up to the superficial fascia layer [18].
  • 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 [29].

Recovery

  • Endoscopic ganglionectomy via flexor carpi radialis tendoscopy is a minimally invasive approach that offers better cosmesis and less soft tissue trauma [4].
  • Arthroscopy is supported as a treatment for dorsal wrist ganglion based on outcomes, recurrence, and complication rates after 4 years of follow-up [9].
  • In children with wrist ganglions, spontaneous resolution usually occurs within 18 months [11].
  • In children aged <10 years, ganglions mainly occur on the volar wrist and can be treated expectantly [17].
  • 69% to 79% of ganglions in children aged <10 years display spontaneous regression within a span of 12-18 months [17].
  • Surgical intervention for wrist ganglions leaves scars and has some risk for adverse events [14].
  • Routine midcarpal joint exploration during arthroscopic excision of dorsal wrist ganglions appeared to reduce recurrence at 1 year without negatively impacting patient outcomes [26].
  • Complete resection of the ganglion stem and complete closure of the joint capsule is the most important step to avoid recurrences [46].

Key Evidence

  • [L4] Surgical excision is a simple, safe, and effective method for treating a painful ganglion of the digital flexor tendon sheath. [1] (10.1007/s11552-007-9028-4)
  • [L4] Percutaneous puncture is a practical option for managing flexor tendon sheath ganglions given its low cost, lack of downtime, and low recurrence rate, with no recurrences observed after a second puncture in this cohort. [2] (10.1177/17531934221115983)
  • [L4] Pediatric ganglions are more commonly found on the volar surface of the hand and wrist and more commonly have tendon sheath origin compared to adults. [3] (10.1007/s11552-008-9122-2)
  • [Paper] Endoscopic ganglionectomy via flexor carpi radialis tendoscopy is a minimally invasive approach that offers better cosmesis, less soft tissue trauma, and the ability to manage concomitant FCR tendon pathology, though it carries risks of recurrence and nerve or vessel injury. [4] (10.1016/j.eats.2017.06.002)
  • [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. [5] (10.1177/1558944720966716)
  • [L4] Tendon associated ganglion cyst is not usual although flexor hallucis longus tendinopathy is common in athletes. [6] (10.1177/2325967114s00211)
  • [L3] Women are significantly more likely to be diagnosed with a volar wrist ganglion, regardless of age or military status. [7] (10.1016/j.jhsa.2016.08.008)
  • [L4] Arthroscopy allows for the simultaneous treatment of ganglions and other pathologies. [8] (10.1016/j.jhsa.2012.04.042)
  • [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. [9] (10.1177/1558944717743601)
  • [L4] In patients with the clinical diagnosis of wrist ganglion cyst, the quality of care would not be compromised by abandoning the practice of routine submission of surgical specimens for pathological examination after excision of the ganglion cyst. [10] (10.1016/s0363-5023(10)60107-4)
  • [L4] In a child with a wrist ganglion, if the cyst ultimately resolved, it usually did so within 18 months. [11] (10.1016/j.jhsa.2019.10.032)
  • [L4] The study concludes that routinely performing wrist radiography is not cost-effective in the evaluation and treatment decision-making process for patients with a wrist ganglion due to a low prevalence of therapeutically significant findings. [12] (10.1007/s11552-007-9032-8)
  • [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. [13] (10.1016/j.jhsa.2008.01.009)
  • [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. [14] (10.1016/j.jhsa.2010.11.048)
  • [L4] Pediatric ganglions of the hand have a greater rate of resolution than ganglions of the wrist. [15] (10.1016/j.jhsa.2023.07.002)
  • [L4] MRI is an excellent diagnostic modality to evaluate rapidly growing upper extremity masses and distinguish ganglions from malignant processes. [16] (10.1007/s11552-007-9083-x)
  • [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. [17] (10.1016/j.jhsa.2021.12.015)
  • [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. [18] (10.1186/s12891-025-08766-x)
  • [L4] Ganglion cysts also have a high association with certain interosseous laxities, and recurrent ganglion cysts originating from the midcarpal joint are not contraindications for arthroscopic resection. [19] (10.1016/j.jhsa.2008.11.025)
  • [L2] Ganglions in pediatric populations, which most commonly affect the dorsal wrist, demonstrate a female predilection. [20] (10.1016/j.jhsa.2021.02.026)
  • [L3] MRI scans provide relatively good reliability in establishing the diagnosis of an occult dorsal wrist ganglion, with a sensitivity of 83% when using intra-operative findings as the standard. [21] (10.1177/1753193408092041)
  • [L4] Intraneural ganglions should be considered in the differential diagnosis of a mass in the vicinity of a nerve. [22] (10.1016/j.jhsa.2015.05.025)
  • [Paper] This method is safer and more reliable for treating volar wrist ganglia. [23] (10.1016/j.eats.2011.12.007)
  • [L4] This case highlights the value of advanced imaging in patients presenting with an atraumatic, painful, and progressive elbow contracture. [24] (10.1016/j.jhsa.2020.06.005)
  • [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. [25] (10.1016/j.jhsa.2010.03.021)
  • [L3] Routine midcarpal joint exploration during arthroscopic excision of dorsal wrist ganglions appeared to reduce recurrence at 1 year without negatively impacting patient outcomes. [26] (10.1177/17531934251405730)
  • [L5] Surgical recurrence rates range from 4% to 40%, and complications include infection, nerve injury, and wrist stiffness. [27] (10.1016/j.hcl.2004.03.015)
  • [L3] The incidence of dorsal wrist ganglia was higher in the military compared with the civilian population. [28] (10.1016/j.jhsg.2020.08.001)
  • [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. [29] (10.1016/j.jhsa.2015.05.030)
  • [L4] Every attempt should be made to identify and excise the articular branch of the involved nerve. [30] (10.1016/j.jhsa.2014.06.095)
  • [L2] Worse hand function was associated with recurrence following prior surgery, worse baseline hand function and lower treatment credibility. [31] (10.1177/17531934231153029)
  • [L4] This case highlights the importance of considering uncommon aetiologies in patients with atypical symptoms of carpal tunnel syndrome. [32] (10.1177/17531934241227809)
  • [L4] Arthroscopic resection is an effective treatment strategy for intra-articular synovial ganglions refractory to conservative measures, providing complete resolution of symptoms and functional recovery with minimal soft tissue damage. [34] (10.1016/j.jhsg.2024.05.007)
  • [L4] Arthroscopic ganglionectomy through an intrafocal cystic portal is a safe and efficacious option for the treatment of painful wrist ganglia. [35] (10.1016/j.arthro.2009.08.021)
  • [L4] Sonography-guided wrist arthroscopy provides several advantages for surgeons, including visualization of the ganglions and ganglion stalk, as well as of the arthroscopic shaver and adjacent structures such as nerves, vessels, and tendons to perform surgery safely. [36] (10.1016/j.jhsa.2012.04.012)
  • [L4] Nonsurgical treatment is largely ineffective in treating ganglion cysts, though it may be considered for symptomatic relief in patients who do not want surgery. [37] (10.1155/2013/940615)
  • [L4] Arthroscopic debridement of ganglion cyst offers excellent outcome without recurrence. [38] (10.1186/1471-2474-13-137)
  • [L1] Open surgical excision offers significantly lower chance of recurrence compared with aspiration in the treatment of wrist ganglions. [39] (10.1016/j.jhsa.2014.12.014)
  • [L4] Ganglion aspiration should be considered as a first-line intervention, with surgical excision remaining an effective option for symptomatic cases. [40] (10.1177/1753193411434376)
  • [L3] Radiologists are less likely to identify occult dorsal ganglion cysts on MRI if the cyst is smaller or if the requisition form does not mention a cyst. [41] (10.1055/s-0039-1683847)
  • [Case_report] Intra-articular ganglion cysts of the cruciate ligaments are difficult to diagnose and do not necessarily require specific clinical symptoms or previous trauma; preoperative MRI is essential for diagnosis, and the condition can be successfully treated by arthroscopy. [42] (10.1007/s00402-003-0494-z)
  • [L4] Ganglion cysts of the cruciate ligaments can easily be detected by MRI and should be arthroscopically resected. [43] (10.1007/s00402-011-1286-5)
  • [Paper] The technique provides good results regarding cyst resorption with fewer complications such as joint stiffness and vascular disturbances. [45] (10.1016/j.eats.2015.05.011)
  • [L4] Complete resection of the ganglion stem and complete closure of the joint capsule is the most important step to avoid recurrences. [46] (10.1007/s001670050073)
  • [L4] Type A ganglion cysts of the radiocapitellar joint may involve compression of the superficial radial nerve. [50] (10.1016/j.otsr.2016.05.014)
  • [L3] Patients with wrist hyperlaxity have a predisposition to developing ganglions, a finding corroborated by independent investigations using similar prospective cohort designs. [53] (10.1016/j.jhsa.2013.11.025)
  • [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. [55] (10.1016/j.arthro.2013.04.002)

References

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[2] Percutaneous puncture of flexor sheath ganglions: an assessment of recurrence. Journal of Hand Surgery (European Volume). 2022. DOI: 10.1177/17531934221115983

[3] Pediatric Ganglion Cysts of the Hand and Wrist: An Epidemiologic Analysis. HAND. 2008. DOI: 10.1007/s11552-008-9122-2

[4] Endoscopic Ganglionectomy of Palmar Ganglion via Flexor Carpi Radialis Tendoscopy. Arthroscopy Techniques. 2017. DOI: 10.1016/j.eats.2017.06.002

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

[6] Ganglion Cyst Contiguity of the Flexor Hallusis Longus Tendon in a National Swimmer. Orthopaedic Journal of Sports Medicine. 2014. DOI: 10.1177/2325967114s00211

[7] Incidence and Risk Factors for Volar Wrist Ganglia in the U.S. Military and Civilian Populations. The Journal of Hand Surgery. 2016. DOI: 10.1016/j.jhsa.2016.08.008

[8] 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

[9] 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

[10] Necessity of Routine Pathological Examination following Surgical Excision of Wrist Ganglions. The Journal of Hand Surgery. 2010. DOI: 10.1016/s0363-5023(10)60107-4

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

[12] The Use of Routine Wrist Radiography is Not Useful in the Evaluation of Patients with a Ganglion Cyst of the Wrist. HAND. 2007. DOI: 10.1007/s11552-007-9032-8

[13] 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

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

[15] 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

[16] Compression Neuropathy of the Radial Nerve Due to Ganglion Cysts. HAND. 2008. DOI: 10.1007/s11552-007-9083-x

[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] 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

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

[20] 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

[21] Magnetic Resonance Imaging in the Diagnosis of Occult Dorsal Wrist Ganglions. Journal of Hand Surgery (European Volume). 2008. DOI: 10.1177/1753193408092041

[22] Intraneural Ganglions of the Hand and Wrist. The Journal of Hand Surgery. 2015. DOI: 10.1016/j.jhsa.2015.05.025

[23] Sonography‐Assisted Arthroscopic Resection of Volar Wrist Ganglia: A New Technique. Arthroscopy Techniques. 2012. DOI: 10.1016/j.eats.2011.12.007

[24] Atraumatic, Progressive, and Painful Elbow Contracture From a Ganglion Cyst. The Journal of Hand Surgery. 2021. DOI: 10.1016/j.jhsa.2020.06.005

[25] 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

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

[27] Ganglion cysts and other tumor related conditions of the hand and wrist. Hand Clinics. 2004. DOI: 10.1016/j.hcl.2004.03.015

[28] Epidemiology of Symptomatic Dorsal Wrist Ganglia in Active Duty Military and Civilian Populations. Journal of Hand Surgery Global Online. 2020. DOI: 10.1016/j.jhsg.2020.08.001

[29] 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

[30] Intraneural Ganglions of the Hand and Wrist. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2014.06.095

[31] 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

[32] Carpal tunnel syndrome caused by an interosseous ganglion of the lunate. Journal of Hand Surgery (European Volume). 2024. DOI: 10.1177/17531934241227809

[34] Intra-articular Synovial Ganglion of the Wrist. Journal of Hand Surgery Global Online. 2024. DOI: 10.1016/j.jhsg.2024.05.007

[35] Arthroscopic Ganglionectomy Through an Intrafocal Cystic Portal for Wrist Ganglia. Arthroscopy. 2010. DOI: 10.1016/j.arthro.2009.08.021

[36] Sonography-guided Arthroscopy for Wrist Ganglion. The Journal of Hand Surgery. 2012. DOI: 10.1016/j.jhsa.2012.04.012

[37] Treatment of Ganglion Cysts. ISRN Orthopedics. 2013. DOI: 10.1155/2013/940615

[38] Ganglion cysts of the cruciate ligaments: a series of 31 cases and review of the literature. BMC Musculoskeletal Disorders. 2012. DOI: 10.1186/1471-2474-13-137

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

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

[41] Radiologist Identification of Occult Dorsal Wrist Ganglion Cysts on MRI. Journal of Wrist Surgery. 2019. DOI: 10.1055/s-0039-1683847

[42] Intra-articular ganglion cysts of the cruciate ligaments: case report and review of the literature. Archives of Orthopaedic and Trauma Surgery. 2003. DOI: 10.1007/s00402-003-0494-z

[43] Diagnosis and treatment of ganglion cysts of the cruciate ligaments. Archives of Orthopaedic and Trauma Surgery. 2011. DOI: 10.1007/s00402-011-1286-5

[45] Arthroscopic Treatment of Intraosseous Ganglion Cyst of the Lunate Bone. Arthroscopy Techniques. 2015. DOI: 10.1016/j.eats.2015.05.011

[46] A ganglion of the superior tibiofibular joint as a mucoid‐cystic degeneration of unusual localization. Knee Surgery, Sports Traumatology, Arthroscopy. 1998. DOI: 10.1007/s001670050073

[50] Type A ganglion cysts of the radiocapitellar joint may involve compression of the superficial radial nerve. Orthopaedics & Traumatology: Surgery & Research. 2016. DOI: 10.1016/j.otsr.2016.05.014

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

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

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