Perioperative management - Ganglionectomy for palmar wrist ganglion

• Pain
• Movement disorder

• Local or general conditions that surgically or anesthesiologically contraindicate an elective operation or are preoperatively improvable

• Clinical examination:
  → Inspection/Palpation of a painful thickening along the course of the radial artery at the flexor side of the wrist
• Ultrasound: Detection of a fluid-filled cavity with connection to the radiocarpal joint, scaphotrapezoid or radioscaphoid joint
• If necessary, MRI in case of unclear findings

• no special preparation of the patient necessary
• generally outpatient procedure
• Clarification of contraindication for bloodless field (e.g., existing shunt in dialysis)

Information about

• surgical method
• extension procedures such as e.g. reconstruction of A. radialis, nerve

• general surgical risks
  • wound healing disorder
  • tendon injury
  • functional deficit wrist/hand
  • CRPS 

• specific surgical risks
  • injury to R. superficialis N. radialis or N. cutaneus antebrachii lateralis with neuropathic pain
  • injury to A. radialis
  •  protracted scar pain (usually subsides after 6 months)
  •  persistent complaints
  • revision surgery
  • risk of recurrence