The authors performed a prospective, non-randomized trial to assess the outcome of open excision, aspiration/injection, and no treatment of dorsal wrist ganglia in 283 patients. At a mean of 70 months, 236 patients responded to a questionnaire. The resolution of symptoms (wrist pain, weakness, and stiffness) was similar between the 3 groups. The cyst recurrence rate was 58% and 39% following aspiration and excision, respectively. In the group of patients who were not treated, the ganglia persisted in 58% of cases. Recurrence after any intervention was associated with more patients being dissatisfied.
The authors of this study conclude that neither excision nor aspiration of dorsal wrist ganglia provides long-term benefit over no treatment in reference to wrist pain, weakness, and stiffness. However, the cyst recurrence rate was significantly lower in patients who underwent surgery. The reported incidence of recurrence following cyst excision in other studies has varied from ~1% to 50%, presumably due to variations in cyst size, configuration, location, surgical technique, and postoperative immobilization.
Wrist, Ganglion, Cyst, Excision, Aspiration