Hand and Wrist
GANGLION
A ganglion is a sac of fluid that originates either from a joint or the sheath of tissue that runs round the tendons. There must be an area of weakness in the lining of the joint or the tendon sheath to allow the fluid to leak out. Ganglia are completely benign lesions and can be left alone unless they are causing pain or functional problems. Sometimes they spontaneously resolve.
There is a special type of ganglion which is also called a Mucous Cyst. This occurs at the fingertip, near the base of the nail. These can cause abnormal growth of the nail. They are caused by arthritis in the underlying joint.
PROCEDURES
Ganglia can occur at various locations. On the back of the wrist they can be suitable for aspiration of the fluid with a needle in the clinic. The success rate for this procedure is about 50% but as it is something that can be done in the clinic without the need for an operation it can still be worth doing. On the front of the wrist there are many tendons, nerves and blood vessels and these are best excised formally rather than being treated by aspiration in the clinic.
Ganglia can be excised but obviously you swap your lump for a scar. Scars usually heal well on the hand and wrist. This does not usually cause a problem. Ganglia on the fingers can be removed under a local anaesthetic whereas wrist ganglia require numbing of the whole arm because the surgery is more complex.
RECOVERY
If you have a ganglion removed from your finger it will only be the finger that has been operated on that is bandaged. If you have a ganglion on your wrist then you will have a bandage that leaves your fingers and thumb free so that the hand can be used for simple activities as soon as the anaesthetic wears off. This dressing is reduced after five days and replaced with a self-adhesive dressing for a further five days.
Most patients are normally driving their cars about a week after surgery. So long as you feel comfortable and have full control of the car this is reasonable. Depending on the nature of your work, your Surgeon will be able to advise you on a timely return. Absorbable sutures are used for this surgery and have usually fallen out two weeks after surgery.
