%0 Journal Article
%T Treatment of Ganglion Cysts
%A Matthew Suen
%A B. Fung
%A C. P. Lung
%J ISRN Orthopedics
%D 2013
%R 10.1155/2013/940615
%X Ganglion cysts are soft tissue swellings occurring most commonly in the hand or wrist. Apart from swelling, most cysts are asymptomatic. Other symptoms include pain, weakness, or paraesthesia. The two main concerns patients have are the cosmetic appearance of the cysts and the fear of future malignant growth. It has been shown that 58% of cysts will resolve spontaneously over time. Treatment can be either conservative or through surgical excision. This review concluded that nonsurgical treatment is largely ineffective in treating ganglion cysts. However, it advised to patients who do not surgical treatment but would like symptomatic relief. Compared to surgery, which has a lower recurrence rate but have a higher complication rate with longer recovery period. It has been shown that surgical interventions do not provide better symptomatic relief compared to conservative treatment. If symptomatic relief is the patient¡¯s primary concern, a conservative approach is preferred, whilst surgical intervention will decrease the likelihood of recurrence. 1. Introduction Ganglion cyst is the most common soft tissue swelling in hand and wrist. It occurs most commonly on the dorsal side of the wrist (70%), followed by volar side (20%) of wrist and tendon sheath of fingers. Most of the ganglion cysts are asymptomatic besides swelling. Most patients sought advice and treatment because of the cosmetic appearance or they were concerned that their ganglion was a malignant growth [1]. Treatment options include reassurance, nonsurgical means like aspiration with or without steroid injections or hyaluronidase and surgical excision. We review the treatment outcome of ganglion in the literature and compare their recurrence and complication rates. 2. Methods Electronic databases of Medline, PubMed, and the Cochrane libraries were searched with the key words ¡°ganglion,¡± ¡°conservative treatment,¡± ¡°surgery¡± and ¡°outcomes.¡± The inclusion criteria were (1) publication in English and (2) articles concerning the treatment of ganglion of hand and wrist. Recurrence rate, complications, and functional outcome were reviewed. References in review articles were screened for potentially relevant studies not yet identified. 3. Reassurance Majority of patients with ganglion do not have symptoms besides swelling, while others may present with pain, weakness, or paresthesia. Barnes et al. reported in their review that only 19.5% had symptoms other than a mass [2]. Westbrook et al. also reported majority of patients sought advice and treatment because of the cosmetic appearance or they were
%U http://www.hindawi.com/journals/isrn.orthopedics/2013/940615/