Winek Nathan C, Ren Mark, Kirkwood Grace, Paskey Taylor, Strauch Robert J
Orthopedic Surgery, Columbia University College of Physicians and Surgeons, New York, USA.
Cureus. 2025 May 13;17(5):e84039. doi: 10.7759/cureus.84039. eCollection 2025 May.
Aim Ganglia are the most common masses of the hand. While benign, they can be symptomatic. Nonsurgical treatment includes observation, manual rupture, puncture, or aspiration. There is a broad range of recurrence rates cited in the literature with aspiration and puncture. The purpose of this study is to determine recurrence rates and patient satisfaction after a simple puncture of the hand and wrist ganglia. Materials and methods We retrospectively identified a cohort of consecutive new patients arriving at the senior author's (RS) office from 2020 to 2022 who underwent simple puncture of a ganglion. Patients were examined by the senior author and the diagnosis of a ganglion was confirmed upon simple puncture with expression of mucinous fluid. A chart review was performed to collect basic demographic data, location of ganglion, and duration of symptoms. Patients were then contacted via telephone and their satisfaction and the rate of recurrence was determined. Results There were 64 patients identified as having undergone puncture of their ganglia. There were 34 patients able to be reached via telephone and 56% of the ganglia recurred with an average time to recurrence of 43 weeks. Of the 34 patients that participated, 79% (27/34) reported that they would choose simple puncture again if they had another ganglion and 76% (26/34) reflected favorably on the puncture procedure. Of the 19 patients with recurrence, eight patients underwent an additional procedure: four underwent surgery and four underwent repeat puncture, with a 75% recurrence rate in the repeat puncture group. Conclusions Our series demonstrates a recurrence rate of 56% for hand and wrist ganglia after simple needle puncture with no complications and high patient satisfaction. The literature has conflicting evidence regarding the optimal treatment of hand and wrist ganglia, however, a simple needle puncture is a reasonable first step in treating ganglia and can immediately confirm the diagnosis of a ganglion.
目的 腱鞘囊肿是手部最常见的肿物。虽然是良性的，但可能会引起症状。非手术治疗包括观察、手法挤破、穿刺或抽吸。文献中报道的抽吸和穿刺的复发率范围很广。本研究的目的是确定手部和腕部腱鞘囊肿单纯穿刺后的复发率及患者满意度。材料与方法 我们回顾性确定了一组2020年至2022年连续到资深作者（RS）办公室就诊并接受腱鞘囊肿单纯穿刺的新患者。患者由资深作者进行检查，通过穿刺抽出黏液性液体确诊为腱鞘囊肿。进行病历审查以收集基本人口统计学数据、腱鞘囊肿位置和症状持续时间。然后通过电话联系患者，确定他们的满意度和复发率。结果 确定有64例患者接受了腱鞘囊肿穿刺。有34例患者能够通过电话联系上，腱鞘囊肿的复发率为56%，平均复发时间为43周。在参与的34例患者中，79%（27/34）表示如果再次出现腱鞘囊肿，他们会再次选择单纯穿刺，76%（26/34）对穿刺过程给予好评。在19例复发患者中，8例患者接受了额外的治疗：4例接受了手术，4例接受了重复穿刺，重复穿刺组的复发率为75%。结论 我们的系列研究表明，手部和腕部腱鞘囊肿单纯针刺后的复发率为56%，无并发症，患者满意度高。关于手部和腕部腱鞘囊肿的最佳治疗方法，文献中的证据相互矛盾，然而，单纯针刺是治疗腱鞘囊肿的合理第一步，并且可以立即确诊腱鞘囊肿。
