The results of treatment of hygromia of the wrist joint in children using a minimally invasive method

Background: Hygroma is the most common tumor–like formation of the hand in children. Hygromas are distinguished by a variety of names (ganglion, synovial cyst, synovioma, bursitis), the lack of common views on etiopathogenesis and treatment, the frequency of relapses and disappearance without treatment. Currently, there are many ways to treat hygroma, which can be divided into two large groups: radical surgical and gentle surgical methods of treatment.

Aims: - compare the results of treatment of wrist joint hygromia in pediatric patients with radical and minimally invasive methods of treatment according to literature data and our own observations.

Methods. For the period 2020-2025, a study was performed based on the analysis of the treatment results of 137 patients with wrist joint hygroma aged 7 to 17 years. All patients were divided into two groups. In the first group (n= 90), a minimally invasive treatment method was used: puncture of the hygroma with extraction of the contents, administration of a sclerosing drug (70% alcohol, exposure – 1 min). Patients of group 2 (n=47) underwent radical surgical treatment with resection of the main cyst, cyst pedicle and cuff adjacent to the joint capsule. Treatment results were monitored after one, 14 and 30 days, and long–term results were monitored after a year in all operated patients.

Results. In the first group, the median DASH score decreased over the year from 37 points (before treatment) to 1 point, and the pain intensity index for VAS decreased from 67 points before treatment to 2 points. The second group also showed positive dynamics, but less pronounced than in the first group. In patients of this group, the DASH score decreased from 39 points before treatment to 21 points after treatment, and on the VAS scale from 68 to 7 points. Statistically significant differences in treatment results between the groups were revealed (p < 0.001). In the 1st group of children with the use of minimally invasive treatment, the recurrence rate was 3% at the follow-up period of 1 year, in the 2nd group, relapses were observed three times more often – 5%.

Conclusions. Thus, a minimally invasive puncture method for the treatment of wrist joint Gyro in children can prevent the development of persistent hand dysfunction, the formation of contractures and ankylosis, prevent the development of relapses, the occurrence of persistent pain syndrome and recurrence of the disease.

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