Ganglion cyst treatment using the ganglion suture technique

Abstract

Ganglion cysts, benign soft-tissue tumors that can occur at any joint, are the most common masses occurring in the hand and comprise 50%-70% of all hand soft-tissue tumors. Despite the high frequency of occurrence, ganglion cyst etiology remains uncertain and perhaps even more elusive is the most appropriate treatment. With 53% of wrist ganglion cysts spontaneously resolving and a nearly equal rate of recurrence after treatment, any invasive management should reliably warrant benefits outweighing presenting complaints. A minimally invasive treatment obtaining a 95% cure rate using 2/0 silk suture was first described in 1988 by Gang and Makhlouf. Although surgical excision remains the accepted gold standard of symptomatic ganglion cysts treatment, we present a series of 7 cases of ganglion cysts treated using a suture technique. Six of the cases involve the dorsal wrist and 1 case involved a rare dorsal foot location. These patients were treated in a community family medicine residency setting. We achieved a 71% cure rate over an average follow-up time of 1 year with a range of 6-24 months. The positive outcomes achieved add to the present body of knowledge on using a suture technique. With a fast learning curve for this technique and the low risk of complications relative to other invasive techniques, we offer that the suture technique should be considered a first line of treatment for symptomatic ganglion cysts.