Abstract
Volar wrist ganglion has a different mode of origin and higher complication rate after excision compared to its dorsal counterpart. This study, which is part of the Trent region ganglion audit, was carried out to prospectively evaluate the natural history and treatment outcome for volar wrist ganglia.
Patients were invited to join the study between 1993 and 1995 following initial consultation with either an orthopaedic or plastic surgeon. Questionnaires were sent within the first year, at two years and finally at five to six years. The final review included a Patient Evaluation Measure (PEM) questionnaire.
Of the 234 patients initially consulted, 186 joined the study, 155 of these responded, 122 at final review and 109 at year two. There were 98 females and 57 males. Three patient groups were identified:
Group I: natural history (no intervention) (N=38)
Group II: aspiration/injection (39)
Group III: excision group (78)
In conclusion, over half of volar wrist ganglia disappear without any intervention between 2 to 5 years. About 45% recur whether aspirated or excised. There is a 18% complication rate with excision, but neither aspiration/injection nor leaving them alone with reassurance was associated with any complications. Irrespective of the treatment, about 80% of patients are satisfied at five years, slightly more than at two years.
This information may form a basis for patient information before deciding treatment. It could also help general practitioners advise patients before hospital referral.
The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom.
