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J Wrist Surg 2023; 12(04): 377-382
DOI: 10.1055/s-0042-1751015
Procedure

Arthroscopic Needling Technique for the Treatment of Wrist Ganglia

Ricardo Kaempf O
1   Department of Hand Surgery, Santa Casa de Misericórdia de Porto Alegre Hospital and Mãe de Deus Hospital, Porto Alegre, Brazil
,
Gustavo Gómez
2   CLIMBA (Clinica de La Mano Buenos Aires), Buenos Aires, Argentina
,
João P. F. Brunelli
1   Department of Hand Surgery, Santa Casa de Misericórdia de Porto Alegre Hospital and Mãe de Deus Hospital, Porto Alegre, Brazil
,
Marcio A. Aita
3   Department of Hand Surgery, ABC Medical School, Santo André, Brazil
,
Vicente Carratalà
4   Department of Orthopedic Surgery, Traumatology Service, Unión de Mutuas and Quirónsalud Hospital of Valencia, Spain
,
Pedro J. Delgado S
5   Department of Hand Surgery, Hospital Universitário HM (Hospitales de Madrid) Montepríncipe, Madrid, Spain
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Abstract

Background Synovial cysts (SCs) are the most frequent wrist tumors; the arthroscopic treatment presents good results when surgery is indicated for symptomatic or patients with cosmetic concerns. The tumoral lesion should be arthroscopically decompressed or drained toward the inside of the joint through pedicle opening and resection of a small portion of the capsule. Hence, the cyst pedicle must be found for the success of this technique.

Description of Technique Some tricks have already been described to facilitate SC location during arthroscopy. We describe an indirect technique that employs an 18-G needle to enhance SC pedicle location and drainage. The technique involves a puncture on the interval of the carpal extrinsic ligaments where the pedicle is suspected to be remain. When found, cyst is drained with a single-puncture motion of the need which promotes cyst content extravasation due to pressure toward the joint.

Patients and Methods This method has been employed in 16 patients, including 9 with dorsal cysts, and seven with volar cysts.

Results All patients presented complete recovery and symptom improvement in up to 30 days, with total disappearance of the cyst. There were no relapses or severe complications within the 12-month follow-up.

Conclusion This is a safe, useful technique that facilitates location of intra-articular cyst pedicle, thus avoiding unnecessary damage in healthy tissues with no increased costs.

Keywords

wrist ganglion - dorsal ganglion - volar ganglion - wrist arthroscopy - arthroscopic resection - surgical excision


Publication History

Received: 18 January 2022

Accepted: 16 May 2022

Article published online:
11 July 2022

© 2022. Thieme. All rights reserved.

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