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Ganglion surgery

Ganglion cysts are the most common mass or lump in the hand.

The cyst rises out of the joint space like a balloon or stalk. It grows out of the tissues that surround the joint such as the ligaments, tendons and linings of the joint. The fluid in the cyst is a thick slippery fluid, similar to the type that lubricates your joints.

Ganglion.jpg

They are usually harmless and can occur in various locations on the hand, but most commonly develop on the back of the wrist. A cyst developing in this position is called a dorsal ganglion. A cyst developing on the palm side of the wrist is called a volar ganglion.

GanglionA.jpg

Who gets ganglions?

Ganglions are more common in younger people aged 15 – 40 years of age and women seem to be affected more than men. They are common among people who repeatedly apply stress to the wrist.

What symptoms does it cause?

  • Most ganglions form a visible lump, however smaller cysts can lie hidden under the skin.
  • Most ganglions produce no other symptoms, but if a cyst presses on the nerves that pass through a joint it can cause pain, tingling and muscle weakness. Large cysts, even if they are not painful usually cause concern as they can be unsightly.

How does your doctor or nurse specialist know you have a ganglion?

During consultation your medical history will be discussed you will be asked to describe the symptoms you have been having. You will be asked how long you have had the lump and if it changes in size with activity or if it is painful.
X-rays will not show a ganglion, but an x-ray may be done to rule out arthritis or a bone tumour.
Ultra sounds or MRI scans may be done so that the ganglion can identified, and to determine if the cyst is near nerves/ligaments and blood vessels.

What are the treatment options?

  • Observation – the cyst may disappear in time
  • Immobilisation – Activity to the area of the ganglion can increase its size and symptoms. A wrist brace/splint can be applied to relieve this and you will be referred to an Occupational Hand Therapist for this.
  • Aspiration – the fluid from around the cyst can be drained off, this can temporarily alleviate pain
  • Surgery – this may be recommended if your symptoms are not relieved by nonsurgical options. Surgery involves removing the cyst and the capsule/tendon sheath which is considered the ‘root’ of the ganglion and having stitches to the skin which your GP will remove after 2 weeks.

What complications could occur?

As with any surgery, complications can arise, these include:

  • infection
  • nerve/tendon or blood vessel damage
  • complex regional pain syndrome
  • pillar/scar pain
  • recurrence.

What can I expect after my operation

Wound - Your incision is closed with 4-6 stitches and you will have a large bulky dressing on your hand which you need to keep dry.

The stitches will be removed by your GP at two weeks (you will need to arrange the appointment) and you will be seen again six weeks after surgery by the surgeon who will check the function of your hand.

Going home - You will be able to go home the same day whether you are having a local or general anaesthetic. You will need to ensure someone can pick you up from the hospital.

Activity - You are not to lift anything with your operated hand for two weeks, not even a kettle or pot. This is to ensure that healing can take place.

You can increase the activity after two weeks but you are still not to lift very heavy items for a total of six weeks from surgery date (yes— you can pick up a kettle now, but nothing heavier!)

Working - If you have work that does not include heavy lifting, and is in a clean environment, you can return to work after two weeks, providing your GP agrees.
If you are a manual worker, you cannot work for six weeks in total.
A medical certificate will be provided for you.

Follow-up plan - Two weeks after surgery you have the stitches taken out by your GP and six weeks after surgery you come to clinic so that the surgeon can assess your hand for sensation and movement.

Acknowledgements

Staff of Mater Hospital Brisbane

For more information about Mater Hospital Brisbane—South Brisbane, please call Reception on 07 3163 8111.

Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: PI-CLN-420102
Last modified 23/1/2018.
Consumers were consulted in the development of this patient information.
Last consumer engagement date: 11/10/2017
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