Ganglion removal (hand)

A ganglion is a cyst filled with clear jelly-like material, related to a joint or tendon sheath. The most common position for a ganglion is over the back of the wrist, but ganglia are also found on the front of the wrist close to the radial pulse, in the palm close to the base of the finger arising from the tendon sheath, and over the back of the finger at the end joint, where pressure often causes a groove to form in the nail.

It is not fully understood why a ganglion develops, but it is thought to start with a degenerative process or injury in the capsule or ligaments around the joint, or the fibrous sheath around a tendon. Usually a ganglion forms a smooth prominent lump which may fluctuate in size or even disappear completely, though it may come back again. Some ganglia are painful, especially small ones deep inside the wrist joint, which are difficult to feel.

It is possible to empty the contents with a needle, but the material is viscous and complete emptying is impossible, and the majority refill anyway. It can be a useful temporary measure and occasionally obviates the need for surgery.

Ganglion removal is usually done under local anaesthetic as a day case patient and takes up to 30 minutes. Your surgeon will make a cut over the ganglion and separate it from the nearby tendons, nerves and blood vessels before removal. At the end of the procedure your skin will be closed with stitches.

You should be able to go home the same day and regular exercise should allow you to return to normal activity. The scar is usually acceptable, but may become red and thick especially on the front of the wrist.

Ganglion removal is a routinely performed operation and is very successful. There is a small risk that damage can occur during the procedure, such as damage to an artery or damage to small nerves which may result in a patch of numbness. It is also possible for a ganglion cyst to reappear.

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