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Percutaneous Puncture of Flexor Sheath Ganglions: An Assessment of Recurrence
Background Flexor tendon sheath ganglions (FTSG) comprise up to 15% of hand ganglions. The management is split between two schools of practice: percutaneous puncture or surgical excision. The literature is equivocal as to which holds true superiority in terms of recurrence rates. The cost of surgica...
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| Format: | Thesis |
| Language: | English |
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Division of Plastic and Reconstructive Surgery
2021
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| _version_ | 1867613200782983168 |
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| access_status_str | Open Access |
| author | Najjaar, Azzaam |
| author2 | Hudson, Donald |
| author_browse | Hudson, Donald Najjaar, Azzaam |
| author_facet | Hudson, Donald Najjaar, Azzaam |
| author_sort | Najjaar, Azzaam |
| collection | Thesis |
| description | Background Flexor tendon sheath ganglions (FTSG) comprise up to 15% of hand ganglions. The management is split between two schools of practice: percutaneous puncture or surgical excision. The literature is equivocal as to which holds true superiority in terms of recurrence rates. The cost of surgical excision is higher and the recovery is longer. In addition, surgery also brings with it the potential for surgical complications, both immediate and long term. Percutaneous puncture can be performed at the time of the initial consult and an immediate return to normal activity with no down-time for the patient. The aim of this study is to assess the recurrence rate after percutaneous puncture. We also describe our employed technique. Method The technique for percutaneous puncture involved the use of a 25-gauge needle for ganglion puncture, no sclerosant or corticosteroid was injected, and an immediate post-procedure mobilisation protocol was employed. Patients were identified from clinical records and were followed up at a minimum of six months to check for recurrence. Results Eighteen patients were included in the study, 12 females and 6 males. The majority of FTSG were found to occur in the middle finger. Two patients experienced a recurrence. Both were successfully treated with a repeat puncture. No patients experienced a complication. Conclusion In our study, we show a low recurrence rate obtained with percutaneous puncture of FTSG using a simple technique. No complications were noted in our cohort on follow-up. We, therefore, recommend employing it as a first line treatment in the management of FTSG. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/32930 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:21.936Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2021 |
| publishDateRange | 2021 |
| publishDateSort | 2021 |
| publisher | Division of Plastic and Reconstructive Surgery |
| publisherStr | Division of Plastic and Reconstructive Surgery |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/32930 Percutaneous Puncture of Flexor Sheath Ganglions: An Assessment of Recurrence Najjaar, Azzaam Hudson, Donald Solomons, Michael McGuire, Duncan Plastic and Reconstructive Surgery Background Flexor tendon sheath ganglions (FTSG) comprise up to 15% of hand ganglions. The management is split between two schools of practice: percutaneous puncture or surgical excision. The literature is equivocal as to which holds true superiority in terms of recurrence rates. The cost of surgical excision is higher and the recovery is longer. In addition, surgery also brings with it the potential for surgical complications, both immediate and long term. Percutaneous puncture can be performed at the time of the initial consult and an immediate return to normal activity with no down-time for the patient. The aim of this study is to assess the recurrence rate after percutaneous puncture. We also describe our employed technique. Method The technique for percutaneous puncture involved the use of a 25-gauge needle for ganglion puncture, no sclerosant or corticosteroid was injected, and an immediate post-procedure mobilisation protocol was employed. Patients were identified from clinical records and were followed up at a minimum of six months to check for recurrence. Results Eighteen patients were included in the study, 12 females and 6 males. The majority of FTSG were found to occur in the middle finger. Two patients experienced a recurrence. Both were successfully treated with a repeat puncture. No patients experienced a complication. Conclusion In our study, we show a low recurrence rate obtained with percutaneous puncture of FTSG using a simple technique. No complications were noted in our cohort on follow-up. We, therefore, recommend employing it as a first line treatment in the management of FTSG. 2021-02-23T09:29:23Z 2021-02-23T09:29:23Z 2020 2021-02-23T07:53:02Z Master Thesis Masters MMed http://hdl.handle.net/11427/32930 eng application/pdf Division of Plastic and Reconstructive Surgery Faculty of Health Sciences |
| spellingShingle | Plastic and Reconstructive Surgery Najjaar, Azzaam Percutaneous Puncture of Flexor Sheath Ganglions: An Assessment of Recurrence |
| thesis_degree_str | Master's |
| title | Percutaneous Puncture of Flexor Sheath Ganglions: An Assessment of Recurrence |
| title_full | Percutaneous Puncture of Flexor Sheath Ganglions: An Assessment of Recurrence |
| title_fullStr | Percutaneous Puncture of Flexor Sheath Ganglions: An Assessment of Recurrence |
| title_full_unstemmed | Percutaneous Puncture of Flexor Sheath Ganglions: An Assessment of Recurrence |
| title_short | Percutaneous Puncture of Flexor Sheath Ganglions: An Assessment of Recurrence |
| title_sort | percutaneous puncture of flexor sheath ganglions an assessment of recurrence |
| topic | Plastic and Reconstructive Surgery |
| url | http://hdl.handle.net/11427/32930 |
| work_keys_str_mv | AT najjaarazzaam percutaneouspunctureofflexorsheathganglionsanassessmentofrecurrence |