Introduction and Aims: The volar carpal ganglion (VCG) is a common benign tumor of the hand complicated by multiple recurrences with conventional treatment. Despite being a common condition, we know of no report describing post-operative functional outcome. We evaluated functional outcome, pain, scarring, and recurrence after VCG excision in the last 15 years.
Method: Twenty-eight patients were considered for inclusion in this study. All patients had been surgically treated for volar carpal ganglia in the last 15 years. Of these, 16 were available for follow-up after exclusion of patients who had since deceased, moved, or were otherwise lost to follow-up. Mean follow-up period was 55 months (nine–135 months). Functional outcome of the upper extremity was evaluated using the standard DASH questionnaire. DASH scores can range from zero (no difficulty in performing daily tasks) to 100 (unable to perform daily tasks). Pain, scarring, and recurrence were also assessed.
Results: Sixteen patients who underwent surgical excision of their recurrent volar carpal ganglions were available for follow-up at the time of the study. They included six men and 10 women, with a mean age of 47 (range 11–70 years). The duration of symptoms prior to excision ranged from two to 50 months. Pain was the main reason for surgery while one patient reported that surgery was performed for cosmetic reasons. There were eight patients in the nine-month to three-year follow-up period and the average DASH score was 7.6. The four patients in the three to five-year follow-up period had an average DASH of 8.1. The four patients in the five plus years of follow-up had an average DASH of 1.7. The improvement in functional outcome correlated with time since surgery, however these differences were not statistically significant. Two of the 16 patients had recurrences within six months after excision. Increased pain was reported in these patients only. No patients complained of significant scarring post-operatively.
Conclusion: Multiple treatment modalities including aspiration and surgery are discussed in the literature with great outcome variability. Our series is the first long-term functional assessment after VCG excision. Thus, surgery is an option for treatment of this common condition as evidenced by low recurrence and DASH scores and high patient satisfaction.
