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Evidence summaries

Natural History of Palmar Wrist Ganglion

Half of ganglion cysts of the wrist may resolve spontaneously over 2-5 years. Surgical treatment may not improve prognosis in the long term. Level of evidence: "C"

A prospective study 1 included the responses to a follow-up mail survey from 155 of 233 patients referred to a hand surgeon because of a ganglion of the palmar wrist. Among the respondents, 38 were treated with aspiration, 79 with surgical excision and 38 with reassurance alone. At the time of follow-up (either 2 or 5 years) 42% of the cysts excised and 47% of those aspirated had recurred at the time of follow-up, while 53% of those not treated spontaneously disappeared.

Comment: The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals) and by limitations in study quality.

    References

    • Dias J, Buch K. Palmar wrist ganglion: does intervention improve outcome? A prospective study of the natural history and patient-reported treatment outcomes. J Hand Surg [Br] 2003 Apr;28(2):172-6. [PubMed]

Primary/Secondary Keywords