Abstract
BACKGROUND: Dorsal wrist ganglion (DWG) is a common benign lesion, and its management by wrist arthroscopy (WA) is well documented in the literature; such reports are scarce from North Africa. We aimed to report our early experience with WA-assisted DWG excision from a North African specialized hand surgery unit. METHODS: Twenty patients underwent arthroscopic excision and were evaluated at baseline and at 3, 6, 9, and 12 months postoperatively. Outcomes measured included pain (VAS), DASH score, the Modified Mayo Wrist Score (MMWS), grip strength, and wrist and forearm range of motion (ROM). Operative time, complications, and recurrence were documented. RESULTS: The patients' mean age was 25.9 ± 7.62 years, 70% were females, and 90% were dominant side. The mean operative time was 47.25 ± 8.45 min and declined progressively by approximately -1.23 min, indicative of an improving learning curve. Pain significantly decreased with a preoperative median VAS of 2.0 (IQR 1.75-3.0) to 0.0 (IQR 0.0-1.0) at 12 months (p < 0.001). Disability improved, as DASH scores decreased from a median of 10.85 (IQR 6.70-12.70) to 5.85 (IQR 5.00-10.00) at 12 months (p < 0.001). Grip strength showed a modest improvement (31.15 ± 11.09 to 32.85 ± 10.97; p = 0.014), accompanied by small but significant gains in all planes of ROM throughout follow-up (p ≤ 0.02). The MMWS increased significantly from a median of 87.75 (IQR 85-90) at baseline to 94.0 (IQR 92-95) at 12 months (p < 0.001). No perioperative complications were reported, and by the last follow up, there were no recurrences or surgical scar-related complaints. 90% of the patients were satisfied with the procedure. CONCLUSION: Our early experience was encouraging, where arthroscopic excision of DWG resulted in no early (within 12 months) recurrences, significant improvements in pain and function, and reduced operative time with increasing surgical experience.