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Outcomes of Arthroscopic Ganglionectomy in a Pediatric Population
Ronnie Pezeshk, MD; Oded Ben-Amotz, MD; Douglas M. Sammer, MD; Jonathan Cheng, MD
University of Texas Southwestern Medical Center, Dallas, TX

Introduction: Arthroscopic resection of dorsal wrist ganglia is an established alternative to open excision. However, arthroscopic ganglionectomy has only been reported in adults. The purpose of this study is to evaluate the outcomes and complications of arthroscopic ganglionectomy in a pediatric population, and compare them with those of open excision.
Materials and Methods: A retrospective chart review was performed of all pediatric arthroscopic and open dorsal wrist ganglionectomies performed by two surgeons over a 4 year period. In addition, patient families were contacted and the outcomes of surgery were evaluated by questionnaire.
Results: Eight patients with arthroscopic ganglionectomy (mean age 15 years, range 12-18), and 19 patients with open ganglionectomy (mean age 13 years, range 7-18) were included in the study. No patients in the arthroscopic cohort reported any residual functional limitations at an average of 3 years follow-up, compared to 3 patients in the open cohort that reported mild functional limitations at an average of 2 years follow-up. No patients in the arthroscopic cohort reported residual pain, compared to 9 patients in the open cohort with residual pain at the surgical site. There was one recurrence in the arthroscopic cohort and two recurrences in the open cohort. On a ten-point scar appearance scale, with 1 being not satisfied at all, and 10 being highly satisfied, the average score in the arthroscopic cohort 9, compared to an average score of 7.6 in the open cohort. All patients in the arthroscopic cohort would have the surgery again, whereas two patients in the open cohort would not have the surgery again. Other than the cases of recurrence, and the cases of persistent pain described above, there were no other complications in either cohort.
Conclusion: Arthroscopic ganglionectomy is a reasonable option for the treatment of dorsal wrist ganglia in the pediatric population. Although this study population was small, outcomes after arthroscopic excision compared favorably with those after open excision.

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