Removal Of Ganglion
The Condition
A Ganglion is a fluid-filled swelling. The fluid is called synovial fluid. This comes from either a nearby joint or from the fluid that lubricates a tendon.
The swelling is caused by either leakage of the fluid from a weakness in the lining of the joint, or a weakness in the tendon lining.
Surgery is designed to remove the swelling and to close up the area of weakness in the lining of the joint or the tendon sheath.
We cannot guarantee that further leakage of fluid, causing another ganglion, will not occur from another part of the joint or tendon lining or, indeed, from the same place.
It is difficult to give an accurate figure for the likelihood of the ganglion coming back as this depends on the area from which the ganglion is removed. Although the recurrence rate can be as high as 30 – 40%, we usually find that with the ganglion around the wrist, that the figure is less than that, at perhaps 15 – 20%.
We can, of course, not predict who is going to get a recurrence, but it is important that you realise that we cannot give a guarantee that the ganglion does not come back again.
After surgery for a ganglion arising from the finger, or from the wrist, a lightweight splint may be used to restrict the range of movement of the joint for about 2-3 weeks only. You will be able to move all your fingers freely whilst the wrist is splinted.
The Operation
Surgery is carried out on a day case basis. For ganglion of the wrist, we often close the wound with glue rather than stitches. To reduce pain after surgery we put a lot of local anaesthetic into the wound. Immediately after surgery your finger or hand, will therefore feel numb and not painful. This can last 6 hours or so, when your hand sensation returns you will not have a lot of pain, other than perhaps an ache.
Risks of Surgery
- The ganglion may recur – about 20% of all operations
- The wound may be noticeable – about 1% of all operations
- After any cut, it is possible to get infection – about 1 – 2 % of all operations
- There may be sensitivity of the wound – about 1 – 2 % of all operations
- After surgery for ganglion of the wrist there may be stiffness of the wrist – about 2% of all operations.
- Circulation disturbance (sympathetic dystrophy or regional pain syndrome) can occur in approx 1% of all operations. Prompt treatment with medication or injection is usually very effective. You will be reviewed regularly after surgery so this or any other complication, is treated promptly.
Green – Textbook of Hand Surgery
Bulstrode – Textbook of Orthopaedic Surgery
Internet sites:
www.mayoclinic.com www.orthogate.com