Prognosis of wrist ganglion operations

A retrospective study was conducted to evaluate the results of treatment of 40 wrist ganglia operated under local anesthesia over four years. The mean follow-up period was 27 months (range 6-48 months). There were 24 dorsal and 16 volar ganglia. The mean complication rate was 56% for volar ganglia, 12.5% for dorsal ganglia, and the difference was significant (p < 0.05). The recurrence rates were 31.2% and 8.3%, respectively (mean 17.5%). There was evidence of nerve damage to the superficial branch of the radial nerve in one patient (dorsal cyst) and to the palmar cutaneous branch of the median nerve in two patients (volar cysts). The mean nerve injury rate was 7.5%. In two patients with volar ganglia, the palmar superficial branch of the radial artery was lace-rated and had to be ligated. The significantly higher complication rate after excision of volar ganglia in contrast to dorsal ones might indicate that the former should be approached more carefully in contrast to dorsal ones and preferably by a senior surgeon.