Soft tissue procedure: excision of ganglion over volar aspect of wrist
72 year old lady presented with a
swelling over volar aspect of wrist approx. 2.5 cm by 2.5 cm in size. The
swelling had been there for 2 years and was gradually increasing in size. There
was no pain in swelling per se; however wrist movement were mildly painful at
terminal flexion. Upon examination, the
swelling was soft to firm, non-pulsatile and slightly compressible. X-rays were
done and found to be normal. Ultrasound of the swelling reported it as
ganglion. The patient was taken to operation theatre and swelling exposed using
volar approach to wrist. First radial was identified and protected. There was
anatomical aberration due to swelling as the radial artery was prematurely
branching and the wrist volar branch as passing right over the swelling. The radial
artery and its branches were separate and protected. The swelling was full of
gelatinous material. The swelling was excised without rupturing it and making
sure all the walls are removed. The wound was thoroughly washed and closed.
Biopsy of the swelling confirmed it to be ganglion.