Novosti
Khirurgii

 This journal is
indexed in Scopus
journal cover
android icon Android Applicaion

Year 2023 Vol. 31 No 3

CASE REPORTS

I.B. GOGINAVA 1, S.A. GOLOBOROD’KO 2, 3

INTRATENDINOUS GANGLION OF THE FINGER EXTENSOR OF THE HAND: CASE REPORT

West Georgia Medical Center1, Kutaisi 1, Georgia.
Kharkov National Medical University 2,
KNP HOS “Regional Clinical Traumatological Hospital” 3, Kharkov,
Ukraine

We present a case of a patient with an intratendinous ganglion of the extensor pollicis brevis. This type of pathology is extremely rare and only 23 cases of intratendinous ganglion of the flexor and extensor tendons of the fingers were described in the scientific literature.. A 38-year-old male came to the clinic with complaints of a severe limitation of active extension of the proximal phalanx and radial abduction of the thumb, dysfunction of the right hand. The patient noted that a few months ago, for no reason, the proximal phalanx gradually began to lose the usual amplitude of active extension and radial abduction. On clinical examination, active extension of the proximal phalanx and radial abduction of the thumb were impaired. Somewhat distally to the styloid process of the radius, in the area of the projection of the tendon of the extensor pollicis brevis, a tight-elastic, o-shaped, painless tumor-like formation 3-4 mm in diameter was palpated. When trying to actively flex and extend the thumb, the formation did not move. After a clinical examination, the preliminary diagnosis was established: closed injury of the tendon of the extensor pollicis brevis of the right hand? Intraoperatively, the intratendinous ganglion of the extensor pollicis brevis was found. Ganglion was completely enucleated. The tendon of the extensor pollicis brevis was closed by a running suture with a polypropylene thread 5/0. Pathological examination confirmed the presence of a ganglion. 5 months after the operation, no recurrence was detected, the amplitude of all active movements in the joints of the thumb was completely restored. We operated on 3 patients with intratendinous ganlion of the extensor tendon of the fingers of the hand. In surgical treatment, the most preffered method is enucleation of the ganglion while maintaining the integrity of the tendon. Depending on the condition of the tendon, a twisting reinforcing suture is applied or not applied. With a significant lesion of the tendon or its severe thinning, a section of the tendon is resected along with the ganglion and either autoplasty, or transposition of the tendon is performed.

Keywords: intratendinous ganglion, finger extensor, hand.
p. 250-254 of the original issue
References
  1. Wang GH, Mao T, Chen YL, Xu Ch, Xing SG, Ni XJ, Deng AD. An intraneural ganglion cyst of the ulnar nerve at the wrist: a case report and literature review. J Inter Med Res. 2021; 49(1): 1–7. doi: 10.1177/0300060520982701
  2. Deng DY, Yee K, Burkhalter W, Okimoto ÊC, Kon Ê, Kurahara DK. An intra-articular ganglion cyst in a patient with juvenile idiopathic arthritis. Pediatr Rheum. 2014; 12:14: 1-4. doi: 10.1186/1546-0096-12-14
  3. Kim YJ, Chae SU, Choi BS, Kim JY, Jo HJ. Intramuscular ganglion of the quadriceps femoris. Knee Surg Relat Res. 2013; 25(1): 40-2. doi: 10.5792/ksrr.2013.25.1.40
  4. Sakamoto A, Oda Y, Iwamoto Y. Intraosseous ganglia: a series of 17 treated cases. BioMed Res Intern. 2013; ID 462730: 1-4. doi: 10.1155/2013/4627305.
  5. Tomori Y, Motoda N, Nanno M, Majima T. Intratendinous ganglion of the extensor pollicis longus: case report and literature review. J Nippon Med Sch. 2021; 88: 500-5. doi: 10.1272/jnms.JNMS.2021_88-416
  6. Kuliński S, Gutkowska Î, Mizia S, Gosk J. Ganglions of the hand and wrist: Retrospective statistical analysis of 520 cases. Adv Clin Exp Med. 2017; 26(1): 95–100. doi: 10.17219/acem/65070
  7. Gude W, Morelli V. Ganglion cysts of the wrist: pathophysiology, clinical picture, and management. Curr Rev Musculoskelet Med. 2008; 1: 205–11. doi: 10.1007/s12178-008-9033-4
  8. Ashkenasi A.I. Khiurgiia kistevogo sustava. Moscîw: Meditsina;1990. ð.352
  9. Wolfe SW, Pederson WC, Kozin SH, Cohen MS. Green’s operative hand surgery. 8th ed. Philadelphia, PA: Elsevier; 2022. 2400 p.
  10. Shanks C, Schaeffer T, Falk DP, Nunziato C, Hogarth DA, Bauer AS, Shah AS, Gottschalk H, Abzug JM, Ho ChA. The efficacy of nonsurgical and surgical interventions in the treatment of pediatric wrist ganglion cysts. J Hand Surg Am. 2022; 47(4): 341-7. doi: 10.1016/j.jhsa.2021.12.005
  11. Trumble TE, Rayan GM, Budoff JE, Baratz ME, Slutsky DJ. Principles of hand surgery and therapy. 3rd ed. Philadelphia, PA : Elsevier, Inc.; 2017. 796 p.
  12. Head L, Gencarelli JR, Allen M, Boyd KU. Wrist ganglion treatment: systematic review and meta-analysis. J Hand Surg Am. 2015; 40(3): 546-53. doi: 10.1016/j.jhsa.2014.12.014
  13. Senda H, Jun Mizutani J, Okamoto H. Case report: Intratendinous ganglion of the hand: two case reports occurring in the extensor digitorum communis and the flexor digitorum superficialis tendon. Case Rep Plast Surg Hand Surg. 2017; 4(1): 9-12. doi: 10.1080/23320885.2016.1278170
Address for correspondence:
4600, Kutaisi, Javakhishvili str., 83a, , Georgia.
Western Georgia Medical Center1
Head of the Department of Pelvic Fracture Surgery
E-mail: igoginava@evex.ge
MTN: +995568082035
Goginava Irakli B.
Information about the authors:
Goginava Irakli B., Post-Graduate Student, West Georgia Medical Center, Head of the Department of Pelvic Fractures Surgery, Kutaisi, Georgia.
https://orcid.org/0000-0003-3159-852X
Goloborod’ko Sergey A., PhD, Associate Professor, Kharkov National Medical University, Department of Surgery No.6, Kharkîv, Ukraine;
https://orcid.org/0000-0002-0153-8158
Contacts | ©Vitebsk State Medical University, 2007-2023