Ganglions of the hand and wrist are common benign lesions. Ganglions represent 60% of hand and wrist tumors and are a common reason for orthopaedic consultation. Women are three times more likely to be affected than men. Although ganglions affect all age groups, they are unusual in children and most common in young adults. They most frequently arise adjacent to joints and tendons.
Treatment options include observation, aspiration, and surgical excision. Observation is acceptable in most instances. Indications for more aggressive treatment include pain, interference with activity or nerve compression.
The recurrence rate after puncture and aspiration is greater than 50% for ganglions in most locations.
Surgical excision is effective, with a recurrence rate of only 5% if care is taken to completely excise the stalk of the cyst along with a small portion of joint capsule. Ganglion surgery requires a formal operative environment and careful technique in order to minimize injury to adjacent structures and minimize the likelihood of recurrence.