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Predicting successful outcomes of wrist and finger Ganglia.
MedLine Citation:
PMID:  23413848     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Introduction: Ganglia are the commonest cause of swellings of the hand and wrist; the documented success of outcomes varies considerably. There is little published data to help predict patients likely to benefit from each treatment modality. We sought to identify factors predicting success of each intervention to provide an evidence basis to inform referral criteria and treatment decisions. Materials and Methods: A retrospective series of 140 serial patients referred with confirmed hand and wrist ganglia between June 2005 and January 2011 was studied to a minimum of 12-month follow-up to determine predictors of successful treatment. Treatment was deemed to be successful if the patient did not develop recurrence. Analysis was completed for predictors of successful treatment at presentation; examining gender, presence of pain, duration of symptoms, anatomic location and treatment modality. Results: Treatment success rate following aspiration was 34% for wrist and 58% for finger ganglia and for surgical excision 7% for wrist and 4% for finger ganglia. Surgical excision was significantly more successful than aspiration (p < 0.01). Duration of symptoms greater than one year was significantly associated with increased recurrence rates (relative risk 2.33, p < 0.05) and male sex was associated with lower recurrence (relative risk: 0.54, p = 0.14). Subgroup analysis of different varieties of soft tissue ganglia did not show any statistically significant factors predictive of recurrence, although both painless presentation and male sex were of borderline significance. Discussion and Conclusions: Duration of symptoms less than one year and male sex can be used to identify patients likely to benefit from interventional treatments and guide treatment decisions. Surgical excision was significantly more successful than aspiration (p < 0.01).
Authors:
K E Rollins; B J Ollivere; P Johnston
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand     Volume:  18     ISSN:  1793-6535     ISO Abbreviation:  Hand Surg     Publication Date:  2013  
Date Detail:
Created Date:  2013-02-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602613     Medline TA:  Hand Surg     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  41-4     Citation Subset:  IM    
Affiliation:
Department of Trauma and Orthopaedics, Addenbrookes Hospital, Hills Road, Cambridge, CB2 0QQ, UK.
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