Ganglion Cysts

A ganglia or cyst is a weakness in the joint or tendon capsule that results in a firm, fluid-filled swelling, and may be associated with pain and/or weakness.

Surgical removal of the cyst is needed when the mass is painful, interferes with function, or causes numbness or tingling of the hand or fingers. Surgery may involve removing the cysts through a small incision in which a camera (arthroscope) is inserted to view the area or through a larger incision, allowing the cysts and surrounding area to be seen directly.

Ganglia or cysts are most commonly seen on the front or back of the wrist (wrist ganglion), just below the nail on back of finger (mucous cyst) or on the palm of hand at the base of the finger (seed cyst). The size can change with certain activities. They are more common in women

The cause of these cysts in the wrist or base of a finger is unclear. It may be due to trauma (old or new injury) in the area or chronic irritation from work or activities requiring repetitive movements. Some people find that when they stop activity the swelling goes down.

The cysts can be treated with simple drainage but have a high recurrence rate. Surgical removal is often the treatment of choice if they become bothersome.

Surgery 

Cyst excision is done under local freezing while you are awake. You will receive a light dressing or Band-Aid with ointment applied. The sutures are dissolving. You can eat and drink before the surgery.

Recovery

You will need someone to drive you home from the hospital. You can shower 48 hours after surgery. Wound care is simply washing then applying ointment and a light dressing every 1 or 2 days. Dr. MacDonald will see you 10-14 days after surgery to ensure you are healing well.

If you have a very physical job, you should plan to have 4-6 weeks of healing time for the wrist ganglia. If you have a fairly sedentary job, then you can return to work as early as 2-3 weeks after surgery. You need to avoid activities that may increase your blood pressure or require use of your hand, other than minimal daily activities such as dressing or feeding yourself.

Complications

As in any surgery, risks include infection, scarring, delayed wound healing, bruising or bleeding, and incomplete excision or recurrence. Complications in this procedure are relatively uncommon but will be discussed further at the time of consultation. Cyst recurrence is quite high particularly if the activity that causes them to develop is continued.