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Treatment of fingernail deformities secondary to ganglions of the distal interphalangeal joint

1995; Elsevier BV; Volume: 20; Issue: 3 Linguagem: Inglês

10.1016/s0363-5023(05)80118-2

1531-6564

Mary K. Gingrass, Richard E. Brown, Elvin G. Zook,

Musculoskeletal synovial abnormalities and treatments

Ganglions of the distal interphalangeal (DIP) joint are often referred to as mucous cysts. They typically occur in the fifth to the seventh decade of life and are almost always associated with osteophytes or spurting of the DIP joint. Patients typically have clinical evidence of osteoarthritis in other joints. We previously reported on the associated fingernail deformity sometimes found in patients with DIP joint ganglions. 1 In that series, excision of the cyst and debridement of the osteophytes resulted in a normal postoperative nail in 64% of patients. However, mild residual nail deformities were present in 36%. We theorized that avoidance of dissection in the area of the germinal matrix might avoid scarring, thus decreasing permanent postoperative nail deformities secondary to the surgical treatment itself. In 1989 Lowrey and Shepler reported complete resolution of DIP joint ganglions with debridement of the osteophytes only (presented at the 44th Annual Meeting of the American Society for Surgery of the Hand, 1989). We therefore prospectively treated 20 digits with nail deformities secondary to DIP joint ganglions by debridement of the osteophytes only, without excision of the associated ganglion.