Open Surgical Excision with Adjunct Ayurvedic Postoperative Management in Dorsal Wrist Ganglion Cyst

Abstract

Ganglion cysts are frequently seen benign swellings occurring near joints and tendon sheaths, commonly over the dorsal aspect of the wrist. These swellings are usually painless but may gradually enlarge and interfere with wrist movements. The present case report describes the successful management of a dorsal wrist ganglion cyst using open surgical excision followed by Ayurvedic postoperative care. A 25-year-old male attended the Shalya Tantra outpatient department with complaints of swelling over the dorsal side of the left wrist for 5 years. Gradual increase in size was noticed during the previous 4 months, along with mild difficulty during wrist movements. Clinical examination showed a smooth, non-tender, cystic swelling measuring approximately 2×2cm with positive transillumination test. The lesion was clinically diagnosed as a dorsal wrist ganglion cyst. The cyst was excised completely under local anaesthesia through a vertical incision. Thick jelly-like material was observed within the cyst cavity. Complete removal of the cyst along with its pedicle was performed, followed by marsupialisation of the residual wall. Postoperatively, Triphala Guggulu, Gandhaka Rasayana, and Haridra Khanda were administered internally, while local dressing with Jatyadi Taila was carried out for wound healing. Healthy wound healing with minimal scar formation was observed. Wrist movements improved after suture removal, and no recurrence was noted during follow-up. The outcome of this case indicates that surgical excision supported by Ayurvedic postoperative management may help achieve satisfactory recovery in dorsal wrist ganglion cyst.