Sonography-guided arthroscopy for wrist ganglion.
OBJECTIVE
To describe how to combine the complementary features of sonography and arthroscopy to make the arthroscopic resection of wrist ganglions a safer and more reliable surgery.


METHODS
A total of 22 patients with wrist ganglions had sonography-assisted arthroscopic resection. Sonographic visualization of ganglions, adjacent structures (ie, vessels, nerves, and tendons), and the cycling tip of the arthroscopic shaver was assessed. Arthroscopic visualization of the ganglions or ganglion stalk was also assessed. Clinical outcome measures included wrist range of motion, grip strength, and our patient-rated Hand 20 questionnaire.


RESULTS
Sonographic visualization of the ganglion stalk, adjacent structures, and the cycling tip of the arthroscopic shaver was possible in all 22 cases. However, ganglion stalks were visualized by arthroscopy in only 4 cases. The mean range of motion and grip strength were not significantly changed following surgery. However, the mean Hand 20 score was significantly improved from 17 to 6 at final follow-up. Ganglion recurrence was seen in 2 cases at 6 and 8 months after surgery.


CONCLUSIONS
Sonography-guided wrist arthroscopy provides several advantages for surgeons, including visualization of the ganglions and ganglion stalk, as well as of the arthroscopic shaver and adjacent structures such as nerves, vessels, and tendons to perform surgery safely.
Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. michi-ya@med.nagoya-u.ac.jp
Michiro
M
Yamamoto
Shigeru
S
Kurimoto
Nobuyuki
N
Okui
Masahiro
M
Tatebe
Takaaki
T
Shinohara
Hitoshi
H
Hirata
D000293:Adolescent; D000328:Adult; D000368:Aged; D003646:Debridement; D005260:Female; D018737:Hand Strength; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D016059:Range of Motion, Articular; D011795:Surveys and Questionnaires; D013581:Synovial Cyst / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014953:Wrist / Q000000981:diagnostic imaging / Q000601:surgery*