Wrist Ganglion Cyst Treatments: Surgery for Ganglion Cyst Removal

Ganglion cyst is non-cancerous in nature and does not spread to the other parts of the body, but may grow gradually. It looks like a sac of liquid that arises from the fluid filled areas like small joints of the wrist or fluid within the sheath that surrounds the wrist tendons (tissue that connects muscles to bone). Inside the cyst, there is a thick, sticky, clear, colorless jelly like fluid also known as synovial fluid that leaks out from the spaces and becomes a cystic structure. Depending on the size, the cyst may feel firm or spongy. It occurs mainly on the back of the hand, wrist joint, or on the palm side of the wrist. Rarely, it grows on the base of the fingers on the palm, fingertips, on the knee and ankle or on the foot. Also known as the Bible cyst, it is more commonly seen to occur in women, especially between the ages of 20-40.

The cause of ganglion cysts is not still known, but according to some theories, trauma causes the tissues of the joint to break down, forming small cysts, which later join together to form a larger and more obvious mass. The cyst is usually soft and looks like a bump or mass, about 1-3 cm in diameter. It may cause some degree of pain that is continuous and becomes worse during any joint movement.

Wrist Ganglion Cyst Treatments
There are different methods of treatment for wrist ganglion cyst. Aspiration is a non-surgical method in which, the doctor inserts a needle into the ganglion cyst and removes the fluid slowly by suction. Another alternative method is to smash the cyst with a hard object like a book. This pops the cyst and tears the lining of the cyst. One of the best treatments to remove the ganglion cyst is surgery.

Surgery for Ganglion Cyst Removal
In the surgery, the ganglion cyst is shelled out, i.e. both the fluid and the sac is removed. Along with this, the connection to the joint or tension sheath is also blocked. The arm is draped and a pneumatic tourniquet on the upper arm is inflated to stop the flow of blood and avoid injury to the delicate tissues in the region. The surgery includes the dissection of the wall of the ganglion and removal of the cyst and stalk from its origin on the ligament or joint capsule. During the procedure, the cyst is kept intact, as its decompression will make it difficult to identify the limits of the cyst and the ligamentous and capsular attachments. The next step after the excision of the wrist ganglion cyst is the placement of a protective dressing that lasts for 2-3 days. A bulky dressing or a volar splint is applied to minimize the pain, bleeding and swelling. The patient can resume his routine life after few weeks and some motion exercises are encouraged to restore wrist and finger mobility.

The non-surgical treatment leaves behind the cyst lining and there are 50% chances of the cyst being formed again. The surgical treatment for removal of the ganglion cyst is highly effective, but also has a risk of ganglion recurrence. Some surgical complications like infection, bleeding, tendon injury, scarring and vascular injury are also possible.