Arthroscopic versus open excision of dorsal wrist ganglia

BACKGROUND: Dorsal wrist ganglia are the most common benign soft tissue tumors of the wrist, often necessitating surgical intervention due to symptoms or esthetic concerns. Both open and arthroscopic techniques are established treatment options but comparative data on recurrence and functional outcomes remain limited. METHODS: This retrospective cohort study evaluated patients who underwent dorsal wrist ganglion excision between 2017 and 2022. Standardized clinical and ultrasound follow-up was available for 19 patients and formed the basis of the outcome analysis. Functional outcomes were assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and the Patient-Rated Wrist Evaluation (PRWE) questionnaire, and Mayo Wrist Scores. Recurrence was determined clinically and via high-resolution ultrasound imaging. RESULTS: No significant differences were observed between groups regarding clinical recurrence rates or functional outcomes; however, ultrasound-detected recurrence was significantly more frequent in the open surgery group (89% vs. 30%, p = 0.0198), with patients in this group having 15.4-fold higher odds of subclinical recurrence. Functional scores DASH, PRWE, Mayo Wrist) were comparable between groups, indicating similar recovery in terms of pain and upper limb function. CONCLUSION: Arthroscopic and open excision yielded comparable clinical outcomes in this cohort. Ultrasound detected a higher frequency of recurrence, particularly after open excision. The clinical relevance of these findings requires confirmation in larger prospective studies.