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Mucous Cysts

Mucous Cysts

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  • Mucous cysts are a type of ganglion. They originate from the distal interphalangeal (closest to the tip of the finger) joints of fingers.

  • They are filled with joint fluid that condenses over time and forms a gel.

  • They form because joint fluid escapes through a small gap in the joint capsule into the cyst

  • Mucous are not dangerous or cancerous. They are usually very unlikely to cause permanent harm if left untreated.

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  • The exact cause is unknown,

  • An injury or heavy use can cause a cyst to get bigger

  • A joint with arthritis is more likely to develop a Mucous Cyst

  • It becomes more common with ageing.

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  • Most mucous cysts present with a lump.

  • A small cyst may not be visible but can cause pain.

  • They can fluctuate in size.

  • Cyst that press on the nail bed can cause a groove in the finger nail.

  • Mucous cysts can rupture. They discharge clear fluid.

  • An ultrasound can confirm the diagnosis of a Mucous cyst.

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  • Immobilisation with brace/splint to help reduce size of ganglion and relieve discomfort, it does not necessarily ‘cure’ a cyst. 

  • Aspiration draining the fluid out of the cyst with a needle can help alleviate pain and reduce the size temporarily, but will not prevent the ganglion from reforming.

  • Use of an anti inflammatory, for discomfort caused by a ganglion.

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  • If there is constant pain or discomfort 

  • If the cyst ruptures repeatedly.

  • If the cyst

  • –Stop you doing the 'things you have to do' and/or

  • –The 'things you love to do' in life

  • If you would prefer a definitive cure for the problem.

  • If appearance is unacceptable

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  • This surgery is usually done under local anaesthetic

  • The anaethetist commonly gives some sedation (a twilight anaesthetic)

  • It is done as a day case in a hospital

  • –but you cannot drive home after the procedure

  • –and you should not be home alone on the night of your surgery

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  • A skin incision is made directly over the cyst

  • The cyst is removed including the sac and an area of joint capsule where the ganglion originates. 

  • The wound is closed. A dressing and bandage are applied.

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In Hospital

  • A bandage is applied to the hand.

  • It is important that the hand remains elevated ‘higher than your heart’ to help limit swelling

  • If the bandage feels too tight, do not hesitate to remove it.

  • It is usual to leave hospital 2-3 hrs after surgery

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At Home

  • Continue to elevate your arm until swelling in your fingers subside.

  • Move your fingers (making a full fist and straightening your fingers out fully about 10-20 times a day).

  • Keep the wound dry covered and clean.

  • If it is not uncomfortable, leave the bandage in place until your first appointment after surgery

  • Blood thinning medication (if you are on any) can be started 2 days after surgery

  • An appointment usually arranged with my practice nurse at about 1-2 weeks after surgery.

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  • The wound usually heals over 1-2 weeks and any sutures are then removed

  • Self care (washing, dressing, eating) with the operated hand – usually around 5 days

  • Driving: when you are able to control a steering wheel with your operated hand and you are not taking strong pain relief anymore (usually 5-10 days post surgery)

  • Most moderate activities (equivalent to lifting a pot of the stove or pouring a full kettle) can usually be achieved by 4-6 weeks,

  • It can take 3-6 months for stiffness and deep scarring in the site of the operation to resolve.

  • Golf, fishing, cycling etc.: usually around 6-12 weeks, but it can be longer (3 months)

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  • Infection 

  • Stiffness of the joint (wrist/finger).  You will be given some exercises to do at home, but may need hand therapy.

  • It very occasionally happens that the tendon that straightens the joint fails due to the surgery, and it may can result in the tip of the finger drooping.

  • It is common to have a bit of numbness next to the scar. Sometimes the scar can be very sensitive for a long time

  • Recurrence, the excision may be unsuccessful and need to be done again.

  • Very rarely (around one in a thousand)a severe pain reaction , (CRPS) can develop, which can be disabling for years.

  • An anaesthetic can have complications, such as nausea, heart and lung problems. Please discuss it with your anaesthetist before the operation.

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  • Full recovery is usually expected.

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