Ganglions, which are the most common benign cysts of the hands, constitute approximately 50-70% of all soft tissue tumors in the hand. They usually develop on the dorsal (back) and vos (palm) of the wrist as well as the fingers. Approximately 50 percent of these cysts, which can reach 1-2 cm in diameter, pass spontaneously. If they do not disappear, they require treatment, because in addition to creating cosmetic problems, they can also cause severe pain in the use of the wrist and subsequently functional limitation.
IT MAY BE HIDDEN ‘GANGLION CYSTS’!
Acıbadem Fulya Hospital Orthopedics and Traumatology / Hand Surgery Specialist Prof. Dr. Kahraman Öztürk pointed out that it is important to consult a doctor when ganglions seen on the wrists and fingers are noticed, and said, “These cysts can cause severe pain that can seriously restrict the movements of the wrist over time. In addition, if the ganglia associated with ligament tears are not treated, they can cause progressive degeneration of the carpal bones and instability in the wrist, that is, instability, instability. says.
ATTENTION TO SLOW GROWING SPHERE
When we compare it with the incidence in the world, ‘ganglon cysts’ are diagnosed in approximately 25 thousand people every year in our country. These cysts, which are unknown in whom and why they will occur, are more common in women. At least 10 percent of patients have a prior traumatic history, and repeated minor trauma can lead to ganglion development. These cysts, which are filled with mucin, in other words, slimy fluid, usually form on the joint capsule, intercarpal ligaments, tendon or tendon sheath. The cyst appears well circumscribed, white and translucent. Ganglions often present with slow-growing swelling. prof. Dr. Stating that the swelling may be accompanied by pain, weakness and decreased grip strength, Kahraman Öztürk said, “Patients often complain that the swelling grows after the increased activity period and that the pain is additional.” says.
THE CAUSE OF THE PAIN MAY BE A HIDDEN ganglion
Especially in the dorsal wrist, hidden ganglia that appear with pain without causing swelling are also common. Occult dorsal wrist ganglia are defined as unnoticed cystic lesions because they are smaller than 5 mm. prof. Dr. Emphasizing that the occult dorsal wrist ganglia can cause more pain complaints than the visible ganglia, Kahraman Öztürk said, “The occult ganglia can be responsible for unexplained wrist pain and they show a disproportionately sensitive feature. This type of ganglion cysts can cause severe pain on the wrist with lifting movement, strong gripping, turning movements and sports activities. says.
HOW IS IT DIAGNOSED?
Clinically, the presence of soft swelling, movement of the cyst fluid when pressed on examination, and transullimination of the cyst are usually sufficient for the diagnosis. Ultrasound is used to evaluate the extent and size of the cyst, and radiography is used to evaluate carpal bone involvement. Magnetic resonance imaging is more necessary in the case of the “hidden ganglion”.
TREATMENT STARTS WITH NON-SURGERY
The treatment of ganglion cyst begins with non-surgical methods. With non-surgical methods such as the use of wrist rest splint and avoidance of strenuous activities, the ganglion cyst heals spontaneously at a rate of 40-50%. With the continuous use of the wrist splint for 3 months, the pain can disappear and the cyst can shrink. Still, there is a 60% chance of recurrence. Recurrence may develop at the same rate in the treatment performed by evacuating the cyst contents under ultrasound guidance. prof. Dr. Kahraman Öztürk stated that if the swelling adjacent to the artery in the volarine does not decrease with the resting splint or continues to grow, surgical treatment is applied, adding, “Surgical treatment is also applied for pain that occurs with activity in the dorsal ganglia of the wrist or increases during sports.” says.
ARTROSCOPIC SURGERY IS PREFERRED
The surgical procedure involves the removal of the ganglion cyst by open or arthroscopic (minimally invasive surgery with an endoscope) method. prof. Dr. Pointing out that surgical excision, that is, removal of the mass from the body, continues to be the gold standard in the treatment of ganglion cyst, Kahraman Öztürk said, “Cysts with swelling in the dorsal wrist and occult dorsal wrist cysts can be successfully treated with the arthroscopic excision method. The recurrence rate of cysts was also significantly reduced, thanks to surgical techniques that included the removal of the pedicle, in other words, the cyst stem and the entire ganglion structure. The recurrence rate of volar ganglia is slightly higher.” says.
Orthopedics and Traumatology / Hand Surgery Specialist Prof. Dr. Stating that the same success rate is achieved with open surgery in removing the ganglion from the body arthroscopically, Kahraman Öztürk continues: “In addition, partial restriction of movement, infection, neuroma (benign tumor of the nerve), scarring and keloid can be seen in the wrist after open surgery. After arthroscopic removal of the ganglion, there is less cosmetic scarring and the patient begins to use the wrist earlier.”