Longitudinal observation of pediatric hand and wrist ganglia.

The purpose of this study was to examine the behavior of ganglia of the hand and wrist in young children treated without surgery. Fourteen consecutive children, less than 10 years of age, who presented with cysts of the hand and wrist were followed up by a single surgeon. The average age of the patient at the time of diagnosis was 38 months (range, 2 months to 9 years 3 months). The masses included 7 retinacular cysts, 5 volar wrist ganglia, and 2 dorsal wrist ganglia. These cysts had been present for an average of 3.3 months (range, 1-12 months) before medical advice was sought. None of the cysts were painful. Follow-up averaged 33 months (range, 9-112 months), with 79% of all cysts spontaneously resolving, the majority within a year. We believe that a child presenting with a benign hand lesion characteristic of a ganglion cyst should initially be treated by observation.