PDF icon Download PDF
J Wrist Surg 2022; 11(06): 493-500
DOI: 10.1055/s-0042-1743118
Scientific Article

Prospective Evaluation of Push-up Performance and Patient-Reported Outcomes Following Open Dorsal Wrist Ganglion Excision in the Active-Duty Military Population

DesRaj Clark 
1   Department of Orthopedic Surgery, Walter Reed National Military Medical Center, Maryland
,
Marvin Dingle
1   Department of Orthopedic Surgery, Walter Reed National Military Medical Center, Maryland
,
Sameer Saxena
1   Department of Orthopedic Surgery, Walter Reed National Military Medical Center, Maryland
,
Theodora Dworak
1   Department of Orthopedic Surgery, Walter Reed National Military Medical Center, Maryland
,
Kyle Nappo
1   Department of Orthopedic Surgery, Walter Reed National Military Medical Center, Maryland
,
George Christian Balazs
1   Department of Orthopedic Surgery, Walter Reed National Military Medical Center, Maryland
,
George Nanos III
1   Department of Orthopedic Surgery, Walter Reed National Military Medical Center, Maryland
,
Scott Tintle
1   Department of Orthopedic Surgery, Walter Reed National Military Medical Center, Maryland
› Author Affiliations
Funding None.
› Further Information
   Permissions and Reprints
Preview

Abstract

Background Dorsal wrist ganglia (DWG) are a common wrist pathology that affects the military population. This study prospectively evaluates push-up performance, functional measures, and patient-reported outcomes 6 months after open DWG excision in active-duty patients.

Methods Twenty-seven active-duty patients were enrolled and 18 had complete follow-up. Included patients had DWG diagnosis, unilateral involvement, and no previous surgery. The number of push-ups performed within 2 minutes was measured preoperatively and at 6 months. Range of motion (ROM), grip strength, Pain Catastrophization Scale (PCS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, Mayo Wrist Score, and visual analog scale (VAS) pain score were measured preoperatively and at 2 weeks, 6 weeks, 3 months, and 6 months.

Results Push-up performance did not significantly change overall. Wrist flexion, extension, and radial deviation returned to preoperative ranges. Wrist ulnar deviation significantly increased from preoperative range. Grip strength deficit between operative and unaffected extremities significantly improved to 0.7 kg at 6 months from preoperative deficit of 2.7 kg. Mean scores significantly improved for the validated outcome measures—PCS from 6.3 to 0.67, VAS pain scores from 1.37 to 0.18, DASH scores from 12.8 to 4.3, and Mayo Wrist Scores from 80.3 to 89.4. No surgical complications or recurrences were reported.

Conclusions Findings suggest that almost half of active patients may improve push-up performance after DWG excision at 6 months. Significant improvements were seen in wrist pain, ROM, grip strength, and all patient-reported outcomes, which is useful when counseling patients undergoing excision.

Keywords

ganglion cyst - patient-reported outcomes - push-up - open excision - military

Ethical Approval

Informed consent was obtained from all individual participants included in the study and for all associated procedures.


This study was approved by our Department of Research Programs Institutional Review Board, Reference number: EDO-2019-0360, 920935. The Health Insurance Portability and Accountability Act (HIPAA) compliance was maintained when completing this study and handling patient information. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study.




Publication History

Received: 13 August 2021

Accepted: 05 January 2022

Article published online:
23 February 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA