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Arthroscopic Wrist Ganglion Excision

intermediate Level

Primary Indication

Symptomatic dorsal or volar wrist ganglion

Danger Structures

  • undefined - Variable based on approach
  • undefined - Surrounding operative field
  • undefined - Bone surface
  • undefined - Joint surfaces if applicable

Visual Atlas

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Step-by-Step Technique

1

Apply traction tower, 10-15 lbs traction

2

Establish 3-4 portal (between EPL and EDC)

3

Insufflate joint with saline

4

Establish 6R portal (ulnar to ECU)

5

Diagnostic arthroscopy - assess for associated pathology

6

SL ligament tears commonly associated with dorsal ganglia

7

Identify ganglion stalk (usually from scapholunate interval)

8

Use shaver to debride capsule over stalk

9

Excise stalk completely

10

May need to debride SL ligament if degenerative

11

Resect adequate capsular tissue around stalk

12

Volar ganglia: use volar portal with care for radial artery

13

Assess completeness of excision

14

Release traction, close portals