Rotatory subluxation of the scaphoid after excision of dorsal carpal ganglion and wrist manipulation--a case report.

Surgical excision of a ganglion on the dorsum of the wrist is usually a benign procedure. The most frequent complications are transient postoperative stiffness and recurrence of the ganglion. This paper reports the development of a rotatory subluxation of the scaphoid after the manipulation of the wrist of a patient who had developed postoperative stiffness after the surgical excision of a dorsal wrist ganglion. This unusual complication was successfully treated by closed pinning under radiographic control followed by immobilization in palmar flexion. Manipulation of the wrist for the management of postoperative stiffness is rarely, if ever, indicated. Limitation of motion of a wrist without underlying structural changes is best managed by gentle, gradual splinting, both static and dynamic. It is suggested that preoperative x-rays should be obtained as part of the routine workup for a dorsal wrist ganglion.