Surgery For a Wrist Nodule
The most common type of lump or nodule found in the hand and wrist is a ganglion cyst. These fluid-filled masses look like balloons on a stalk and contain a clear, gelatin-like liquid. They are not cancerous and, in most cases, do not require treatment. However, if they become painful or interfere with movement, surgery may be necessary.
Ganglion cysts are a result of minor trauma or microtrauma that causes a small tear in the structure surrounding a joint (ligament, tendon sheath or joint capsule). As a result, joint fluid escapes and the body builds up a wall around it, creating a cyst. Ganglion cysts can occur in any part of the wrist and hand. They can be painful and can grow in size over time. They usually appear in the back of the wrist, but can also be found in the palm side of the wrist or at the top of the end joint of the finger.
They are found in people of all ages, but they are more common in younger individuals and women. Often, the cause is unknown. However, it is believed that they develop when the synovial tissue of the wrist or hand ruptures due to repetitive stress. Other factors that can contribute to their development include arthritis, trauma and other forms of injury, especially repetitive stress injuries.
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Many people choose to have a ganglion cyst removed because it becomes painful or they feel that it is unsightly. The decision to have a cyst removed should be discussed with a board certified hand surgeon who has extensive experience in the surgical and nonsurgical management of bone, nerve, tendon and ligament injuries related to repetitive stress, overuse or trauma. The UChicago Medicine team has extensive expertise in treating these conditions.
A doctor can drain a ganglion cyst by using a needle to draw out the fluid inside of it. However, it is not recommended that this technique be done long-term because it can damage blood vessels and cause a recurrence of the cyst.
Surgery is a safe and effective way to remove the ganglion cyst. During the operation, your doctor makes an incision in the skin and then removes the cyst and part of the strong structures that connect the bones of your wrist and hand together. This reduces the chance of the cyst returning.
After surgery, the area may be tender and swollen. You will need to keep the site elevated and cover it with a bandage or splint until it heals. Acetaminophen or ibuprofen can be used to help reduce pain and swelling. You should be able to return to most activities in two to six weeks.
Although it is rare, a ganglion cyst can return after it has been removed. If the cyst does recur, your doctor can treat it with medications or by surgically removing the cyst again. This is called resection surgery. Resection surgeries are performed on an outpatient basis. Patients can return home the same day of the procedure and most recover within a few weeks.