No treatment: If a ganglion is not painful then usually there is no strong indication for it to be treated. Occasionally a ganglion may spontaneously resolve without treatment.
Aspiration and/or injection: This is sometimes attempted. The results vary but recurrence rates are high.
Surgery: If a ganglion is painful or limiting wrist movement then surgery may be considered.
Normally surgery is performed as a day procedure at the hospital. For wrist surgery usually general anaesthesia or an arm block (a regional local anaesthetic block) is required.
The surgery involves an incision over the area of the ganglion. The cyst is then dissected free of other tissues and is traced down to the neck where it enters the joint capsule. The joint is opened and the origin of the cyst is traced into the joint and totally removed. If this is not done the risk of recurrence of the cyst is high.
After surgery you will have a splint on your wrist preventing movement and a bandage. The splint stops movement to reduce post operative pain and allow the joint capsule tissues which have been repaired to heal properly before exposing the wrist to further stress.
You will likely have splint on your wrist for 3-4 weeks. Your fingers will be free to move normally and this will be encouraged.
The major risk of ganglion surgery is the risk of recurrence. A ganglion can recur after surgery.
As with any surgery there is risk associated with having an anaesthetic. We will discuss these risks at your consultation.
In any elective hand operation there is a small risk of developing a chronic pain syndrome known as chronic regional pain syndrome (CPRS). We can also discuss this in more detail at your consultation.
