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Outcomes and Recurrence Rates of Arthroscopically Resected Dorsal Wrist Ganglion with a Minimum 4-Year Follow up Period
C. H. Fernandes, MD; L. M. Meirelles, PHT; J. B. G. Santos, MD; J. Raduan Neto, MD; F. Faloppa, MD; Sao Paulo Federal University
Universidade Federal de São Paulo , Sao Paulo, Brazil

Introduction: The purpose of this study is to do an objective and subjective evaluation of outcomes of resection of dorsal ganglion cyst of the wrist by of arthroscopic resection and its recurrence rates. Material and Methods: We evaluated twenty dorsal wrist cysts in 23 patients. They have been undergone to an arthroscopic resection of dorsal ganglia of the wrist between December 2000 and January 2008. All surgeries were performed by the same surgeon (CHF) and it was performed by the same technique which was first described by Osterman and Raphael (1995). Two patients had been treated previously with open surgery and 03 with aspiration. The range age of patients varied from 11 to 53, with average 29,4 years. There were 18 women and 5 men. The patients were evaluated retrospectively by average of the visual analog scale of pain, of the Quick DASH questionnaire, of the wrist range of motion, of the palmar grip strength testing and by the presence of recurrence and complications. Results: The range of follow up period was from 49 to 134 months. In postoperative period, The average of the Quick Dash was 4.8 (range, 0-34.1). The flex, extension, radial deviation and ulnar deviation did not differ from preoperative values. The VAS ranged of 0 until 5, with average of 0.59. The palmar grip strength average was 28,6, ranging 10 -48. At minimum of 4 years follow-up, there was 1 recurrence (0.5%), diagnosed before three months after surgery. The patient declined treatment. One patient had hypertrophic scarring. No cases of scapholunate instability were noted Discussion: Excision of the dorsal wrist ganglion is one of the most common procedures performed by hand surgeons. Recurrence of the ganglion is the most frequently reported failure of any form of treatment. The main advantage of arthroscopic treatment is that it provides a direct view of wrist joint. Edwards & Johansen (2009) and Rizzi et al. (2004) showed good functional results and low incidence of recurrence with this surgical technique, but only Tavakkolizadeh & Povlsen (2004) presented a follow up longer than two years. In all studies the recurrence was in the first year. Conclusion: Arthroscopic ganglionectomy is a safe procedure with recurrence and complication rates comparable to open resections


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