shutterstock_43369744What is a ganglion cyst?

A ganglion cyst is a benign mass commonly found on the wrist and the end joints in the fingers.  These typically arise from a joint or a tendon.  They are filled with a thick fluid that acts as a lubricant for the joint or tendon.  The fluid leaks from the joint and is covered by a thick sheath.

(photograph)

What are the symptoms of ganglion cyst?

People will notice a growth on the wrist or fingers.  This growth will often fluctuate in size as the fluid moves in and out of the joint/tendon sheath.  It often has well defined borders.  Usually these are asymptomatic, but they can cause pain with joint motion.

How is a ganglion cyst diagnosed?

It is most often diagnosed by history and physical exam.  An X-ray may be ordered to look at the underlying joint.

What is the treatment for a ganglion cyst?

In most cases, the initial treatment is non-operative.  If the cyst is located in a safe location, aspiration of the fluid with a needle is attempted.  This results in resolution 40% of the time, which is still less morbid than surgery.  If the cyst is not in a location amenable to drainage or it recurs after drainage, then surgical removal is warranted.

What does ganglion cyst surgery involve?

Surgery involves removing the cyst with its capsule.  Often a small piece of the underlying joint capsule or tendon sheath is removed with the cyst.  This prevents recurrence.

What are the main risks of this surgery?

• Swelling, stiffness, and pain
• Infection
• Nerve Damage
• Arterial damage
• Tendon or joint damage
• Recurrence

Post Operative Course

Day 1-14
• Keep dressing/splint clean and dry
• Elevate hand above heart level for next 48 hours to prevent pain and swelling
• Move unaffected digits as much as possible to prevent stiffness

Day 14-3 months
• Splint will be removed at 2 weeks.
• Continue to progressively use your hand
• Therapy may be indicated if you become too stiff

Driving?
You may drive when you are off narcotics and feel confident to control the car.  Most patients are able to drive within a week.

Time off of Work?
This is dependant on the type of work you perform.  Many patients with office jobs only require a few days.  However, patients who perform heavy labor may require 4-5 weeks to recover.