Orthopaedic Surgery

Answer 1 Surgical excision of the cyst by cutting the cyst stalk at the dorsal scapholunate ligament. Surgical excision of the ganglion cyst involves tangentially cutting the entire cyst stalk at its base. The stalk is exposed by blunt dissection and then cut free from its most common attachment site, the dorsal scapholunate ligament. Recurrence rates with this procedure are low as compared with nonsurgical methods. If the cyst sac is removed superficially, the preserved stalk may cause recurrence. Traumatic rupture of the cyst is no longer performed because of the risk of vascular damage and high recurrence rates. Although serial aspirations and aspirations followed by methylprednisolone have shown promising results, aspiration with multiple needle punctures or sclerosing agents is not recommended.1 REFERENCES 1. Nahra ME, Bucchieri JS. Ganglion cysts and other tumor related conditions of the hand and wrist. Hand Clin 2004;20:249-60. Click here to return to the questions

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