Department of Surgery, Universidad de Antioquia, Medellín, Colombia.
Arthroscopy. 2010 Dec;26(12):1675-82. doi: 10.1016/j.arthro.2010.05.008. Epub 2010 Oct 16.
The objective of this study was to review the results of arthroscopic resection of dorsal wrist ganglion (DWG), as well as to describe the senior author's technique and technical details to minimize potential complications.
Between September 1999 and May 2004, 114 patients underwent arthroscopic resection of DWG with a minimum follow-up of 24 months. We describe the surgical technique and discuss our results and complications.
A total of 114 patients (87 female patients and 27 male patients) with a mean age of 33.1 years were treated with our operative technique. The symptoms at presentation were unsightly appearance in 63 (55.2%), pain in 33 (28.9%), and both unsightly appearance and pain in 18 (15.8%). The patients presented between 1 and 96 months before surgery (mean, 17.81 months). Of the patients, 66 (57.9%) had been treated previously with nonsurgical modalities (aspiration) and 1 had undergone open surgery. The origin of the DWG was more commonly related to the midcarpal joint (85 patients [74.6%]). Our surgery brought about a significant improvement in flexion and extension after surgery (P < .005). Similarly, our surgery brought about a significant improvement in grip strength (P < .005). In patients with preoperative pain, treatment also showed a significant impact. At 2 years' follow-up, there were 14 recurrences (12.3%), diagnosed at a mean of 16.86 months after surgery (range, 2 to 25 months). Complications were identified in 6 patients (5.26%), and the mean time off work was 11 days, with a majority of patients returning in less than 1 week.
Arthroscopic DWG resection showed an improvement in functional measurements in addition to relief of pain in a significant proportion of patients. Complications related to the operative technique did not cause any significant long-term functional deficit. The recurrence rate was 12.3%, and patient satisfaction was high. Arthroscopic technique allows patients to use their hand immediately. The results of this study support the use of arthroscopy as primary treatment for DWG resection.
Level IV, therapeutic case series.
本研究旨在回顾关节镜下切除背侧腕关节腱鞘囊肿（DWG）的结果，并描述资深作者的技术和技术细节，以最大限度地减少潜在并发症。
1999 年 9 月至 2004 年 5 月，114 例 DWG 患者接受了关节镜下切除手术，随访时间均至少 24 个月。我们描述了手术技术，并讨论了我们的结果和并发症。
共 114 例（87 例女性和 27 例男性）患者，平均年龄 33.1 岁，采用我们的手术技术进行治疗。术前症状为外观不佳 63 例（55.2%），疼痛 33 例（28.9%），外观不佳和疼痛均有 18 例（15.8%）。患者在术前 1 至 96 个月就诊（平均 17.81 个月）。其中 66 例（57.9%）患者曾接受过非手术治疗（抽吸），1 例患者曾接受过开放手术。DWG 的起源更常见于腕中关节（85 例[74.6%]）。我们的手术使术后屈伸活动明显改善（P<0.005）。同样，我们的手术使握力明显改善（P<0.005）。对于术前有疼痛的患者，治疗也显示出显著的影响。在 2 年的随访中，有 14 例（12.3%）复发，平均在术后 16.86 个月（2 至 25 个月）时被诊断。6 例（5.26%）患者出现并发症，平均停工时间为 11 天，大多数患者在不到 1 周内返回工作岗位。
关节镜 DWG 切除在缓解疼痛的同时，显著改善了患者的功能测量结果。与手术技术相关的并发症并未造成任何明显的长期功能缺陷。复发率为 12.3%，患者满意度高。关节镜技术允许患者立即使用手部。本研究结果支持将关节镜作为 DWG 切除的主要治疗方法。
IV 级，治疗性病例系列。
