SYNOVIAL CYSTS
Reconstructive surgery:
This document has been conceived under the authority of the French Society of Plastic, Reconstructive and Aesthetic Surgery (SOFCPRE).
DEFINITION, AIM AND PRINCIPLES
A cyst is a pocket like a balloon filled with a viscous liquid called synovial fluid.
It manifests as a lump that grows on the back of the wrist most often, in front of the wrist and also on the base of the fingers.
It can be painful on compression or during certain movements.
Its size varies from a few millimetres to several centimetres.
Of sudden or gradual onset, the cyst is developed at the expense of a membrane lining the joints and tendons.
This membrane called synovium secretes the synovial fluid that acts as a lubricant, like oil in the engine of the car.
For various reasons, the synovial tissue may form pockets that are kept in tension by the continuous secretion of the fluid.
Two types of cysts are observed. The cyst communicating with a joint is called arthrosynovial cyst and the cyst developed at the beginning of the tendon sheath is called tenosynovial cyst.
These lumps are benign and aren’t very troublesome as they only cause pain or discomfort in certain movements of the wrist or an unsightly appearance.
It is never urgent to remove a cyst because the spontaneous evolution may be favourable with complete disappearance without any treatment.
BEFORE THE OPERATION
If after several months, the cyst persists and causes any discomfort, an intervention can be proposed.
A preoperative assessment is normally conducted as required.
The anaesthesiologist will be seen in consultation at the latest 48 hours before surgery.
No medication containing aspirin should be taken within 10 days prior to surgery.
Smoking cessation is strongly recommended before surgery.
It is essential to fast (not eat or drink) 6 hours before surgery.
TYPE OF ANAESTHESIA AND HOSPITAL STAY
The procedure is done under regional anaesthesia of the arm without hospitalization unless special indication.
THE PROCEDURE
The surgeon will remove the cyst by an incision that inevitably leaves a scar. This intervention may result in a stiff wrist or finger.
To avoid these disadvantages, a cleaning arthroscopic technique of the synovial cyst is increasingly proposed.
This method involves introducing into the wrist through a small incision, an optic called arthroscope connected to a camera to see inside the wrist on a television screen. Through another small incision, a device designed to vaporise or shaving the synovial tissue allows a joint cleaning and the resorption of the cyst.
This method minimise the painful consequences and the scars.
AFTER THE OPERATION: POSTOPERATIVE CARE AND FOLLOW-UP
Nevertheless, whatever the technique used, you should be aware that relapses are not uncommon, requiring a reoperation in case of persistent discomfort.
POSSIBLE COMPLICATIONS
The usual possible complications are haematomas, infection, recurrence of the cyst, unsightly scars, joint stiffness and finally reflex sympathetic dystrophy manifested by a painful swollen hand, that requires prolonged treatment.
All things considered, the risks must not be overestimated, but you must be conscious that an operation, even a minor one, always has some degree of unforeseeable unknown factors.
You can be assured that if you are operated on by a qualified Plastic Surgeon, he will have the experience and skill required to avoid these complications, or to treat them successfully if necessary.
These are the facts that we wish to bring to your attention, to complement what you were told during the consultation.
Our advice is for you to keep this document and to read it and think it over carefully after your consultation.
Once you have done this you will perhaps have further queries, or require additional information.
We are at your disposal should you wish to ask questions during your next consultation, or by telephone, or even on the day of the operation, when we will meet in any case, before the anaesthesia.
"Copyright", © "All Rights Reserved" SOFCPRE, any reproduction, even partial, of these texts is prohibited without permission from the French Society of Plastic Reconstructive and Aesthetic Surgery. A copy or reproduction by any means whatsoever, including photocopying, photography, screen capture, copy, paste, recording or otherwise, constitutes an infringement punishable under the Act of March 11, 1957 on the protection of copyright.
Authorization for reproduction of March 10, 2009, for: MCEI (www.chirurgiens-plasticiens.info).
This factsheet has been designed under the auspices of the French Society of Plastic Reconstructive and Aesthetic Surgery (SOF.CPRE) as a complement to your first consultation; to try to answer any questions you can ask yourself if you intend to use a surgical lipo-filling.
The purpose of this paper is to bring you all the information necessary and essential for you to make your decision with full knowledge of the facts. So is it advisable to read with the greatest attention.