Mucous Cysts of Fingers: Diagnostics and Treatment Mistakes
- 作者: Chulovskay I.G.1, Egiazaryan K.A.1, Kosmynin V.S.1, Zharov D.S.1, Titov A.A.1
-
隶属关系:
- Pirogov Russian National Research Medical University
- 期: 卷 30, 编号 1 (2024)
- 页面: 14-24
- 栏目: Clinical studies
- URL: https://journal-vniispk.ru/2311-2905/article/view/255300
- DOI: https://doi.org/10.17816/2311-2905-17433
- ID: 255300
如何引用文章
详细
Background. Mucous cysts of hand represent tumor-like masses. This pathology is associated with a large number of diagnostic and treatment mistakes with inappropriate procedures and incomplete surgical interventions, which result in recurrences and complications.
Aim of the study — to analyze diagnostics and treatment mistakes in patients with mucous cysts of fingers in order to improve the quality of medical care for patients with this pathology.
Methods. The study enrolled 62 patients. Diagnostics included medical history analysis, clinical and X-ray examination, and ultrasonography. According to the patients’ history, they were divided into two groups: group 1 consisted of patients who had come to the clinic for the first time, group 2 — of patients who had referred to the clinic with recurrences of mucous cysts. All patients underwent surgical interventions with osteophyte excision of the phalanx and skin defect grafting after cyst excision. Treatment results were evaluated 2, 6, 12 months after the operation using X-ray data, VAS, QuickDash questionnaire, and measurements of the range of motion in the distal interphalangeal joint.
Results. Initial referrals of group 2 patients (with disease recurrence) were analyzed in terms of the profile of specialists and the type of care provided. It was found that patients with recurrence had undergone procedures (cyst puncture, cauterization, removal of thin skin over the cyst) or surgeries without osteophyte excision of the phalanx and skin defect grafting after cyst excision. The use of a diagnostic algorithm at the referral stage made it possible to confirm the diagnosis and detect an osteophyte of the affected phalanx in all patients. Patients were followed up for a year.
Conclusion. At the diagnostic stage, X-ray and ultrasonography are conclusive methods of examination. The only correct method of mucous cysts treatment is radical surgery including skin defect grafting with local tissues after cyst excision and osteophyte removal.
作者简介
Irina Chulovskay
Pirogov Russian National Research Medical University
编辑信件的主要联系方式.
Email: igch0906@mail.ru
ORCID iD: 0000-0002-0126-6965
Dr. Sci. (Med.)
俄罗斯联邦, MoscowKaren Egiazaryan
Pirogov Russian National Research Medical University
Email: egkar@mail.ru
ORCID iD: 0000-0002-6680-9334
SPIN 代码: 5488-5307
Dr. Sci. (Med.), Professor
俄罗斯联邦, MoscowVladimir Kosmynin
Pirogov Russian National Research Medical University
Email: dr.kosmynin@gmail.com
ORCID iD: 0000-0002-1006-4628
俄罗斯联邦, Moscow
Dmitriy Zharov
Pirogov Russian National Research Medical University
Email: dr.zharov@internet.ru
ORCID iD: 0000-0002-3876-6832
俄罗斯联邦, Moscow
Aleksey Titov
Pirogov Russian National Research Medical University
Email: malan97@mail.ru
ORCID iD: 0009-0000-4387-1154
俄罗斯联邦, Moscow
参考
- Jabbour S., Kechichian E., Haber R., Tomb R., Nasr M. Management of digital mucous cysts: a systematic review and treatment algorithm. Int J Dermatol. 2017;56(7): 701-708. doi: 10.1111/ijd.13583.
- Kim E.J., Huh J.W., Park H.J. Digital Mucous Cyst: A Clinical-Surgical Study. Ann Dermatol. 2017;29(1): 69-73. doi: 10.5021/ad.2017.29.1.69.
- Salasche S.J. Myxoid cysts of the proximal nail fold: a surgical approach. J Dermatol Surg Oncol. 1984;10(1): 35-39. doi: 10.1111/j.1524-4725.1984.tb01170.x.
- Чуловская И.Г., Егиазарян К.А., Скворцова М.А., Лобачев Е.В. Ультразвуковая диагностика синовиальных кист кисти и лучезапястного сустава. Травматология и ортопедия России. 2018;24(2):108-116. doi: 10.21823/2311-2905-2018-24-2-108-116. Chulovskaya I.G., Egiazaryan K.A., Skvortsova M.A., Lobachev E.L. Ultrasound diagnostics of synovial cysts of the hand and wrist. Traumatology and Orthopedics of Russia. 2018;24(2): 108-116. doi: 10.21823/2311-2905-2018-24-2-108-116. (In Russian).
- Wolfe S.W., Pederson W.C., Kozin S.H. Green’s Operative Hand Surgery. Elsevier Health Sciences; 2010. 2392 р.
- Rizzo M., Beckenbaugh R.D. Treatment of mucous cysts of the fingers: review of 134 cases with minimum 2-year follow-up evaluation. J Hand Surg Am. 2003;28(3):519-524. doi: 10.1053/jhsu.2003.50088.
- Al-Hourani K., Gamble D., Armstrong P., O’Neill G., Kirkpatrick J. The Predictive Value of Ultrasound Scanning in Certain Hand and Wrist Conditions. J Hand Surg Asian Pac Vol. 2018;23(1):76-81. doi: 10.1142/S2424835518500108.
- Plancher K.D. MasterCases: Hand and Wrist Surgery. Thieme; 2004. 581 p.
- Sobanko J.F., Dagum A.B., Davis I.C., Kriegel D.A. Soft tissue tumors of the hand. 1. Benign. Dermatol Surg. 2007;33(6):651-667. doi: 10.1111/j.1524-4725.2007.33140.x.
- Blume P.A., Moore J.C., Novicki D.C. Digital mucoid cyst excision by using the bilobed flap technique and arthroplastic resection. J Foot Ankle Surg. 2005;44(1): 44-48. doi: 10.1053/j.jfas.2004.11.009.
- Kuwano Y., Ishizaki K., Watanabe R., Nanko H. Efficacy of diagnostic ultrasonography of lipomas, epidermal cysts, and ganglions. Arch Dermatol. 2009;145(7): 761-764. doi: 10.1001/archdermatol.2009.61.
- Наумов А.В., Воробьева Н.М., Ховасова Н.О., Мороз В.И., Мешков А.Д., Маневич Т.М. и др. Распространенность остеоартрита и его ассоциации с гериатрическими синдромами у лиц старше 65 лет: данные российского эпидемиологического исследования ЭВКАЛИПТ. Терапевтический архив. 2021;93(12):1482-1490. doi: 10.26442/00403660.2021.12.201268. Naumov A.V., Vorobyeva N.M., Khovasova N.O., Moroz V.I., Meshkov A.D., Manevich T.M. et al. The prevalence of osteoarthritis and its association with geriatric syndromes in people over 65: data from the Russian epidemiological study EVKALIPT. Ter Arkh. 2021;93(12):1482-1490. doi: 10.26442/00403660.2021.12.201268. (In Russian).
- Kim J.Y., Lee J. Considerations in performing open surgical excision of dorsal wrist ganglion cysts. Int Orthop. 2016;40(9):1935-1940. doi: 10.1007/s00264-016-3213-4.
- Kuliński S., Gutkowska O., Mizia S., Gosk J. Ganglions of the hand and wrist: Retrospective statistical analysis of 520 cases. Adv Clin Exp Med. 2017;26(1):95-100. doi: 10.17219/acem/65070.
- Epstein E. A simple technique for managing digital mucous cysts. Arch Dermatol. 1979;115:1315-1316.
- Mahdavian Delavary B., Cremers J.E., Ritt M.J. Hand and wrist malpractice claims in The Netherlands: 1993-2008. J Hand Surg Eur Vol. 2010;35(5):381-384. doi: 10.1177/1753193409355735.
- Егиазарян К.А., Магдиев Д.А. Анализ оказания специализированной медицинской помощи больным с повреждениями и заболеваниями кисти в городе Москва и пути ее оптимизации. Вестник травматологии и ортопедии им Н.Н. Приорова. 2012;19(2):8-12. doi: 10.17816/vto2012028-12. Egiazaryan K.A., Magdiev D.A. The analysis of rendering of specialized medical care by the patient with damages and hand diseases to the city of Moscow and ways of its optimization. N.N. Priorov Journal of Traumatology and Orthopedics. 2012;19(2):8-12. doi: 10.17816/vto2012028-12. (In Russian).
- Longhurst W.D., Khachemoune A. An unknown mass: the differential diagnosis of digit tumors. Int J Dermatol. 2015;54(11):1214-1225. doi: 10.1111/ijd.12980.
- Starr H.M. Jr, Sedgley M.D., Means K.R., Murphy M.S. Ultrasonography for Hand and Wrist Conditions. J Am Acad Orthop Surg 2016;24(8):544-554. doi: 10.5435/JAAOS-D-15-00170.
- Chen I.J., Wang M.T., Chang K.V., Liang H.W. Ultrasonographic images of the hand in a case with early eosinophilic fasciitis. J Med Ultrason (2001). 2018;45(4),641-645. doi: 10.1007/s10396-018-0872-3.
- Vanmierlo B., Vandekerckhove B., DE Houwer H., Decramer A., VAN Royen K., Goubau J. Digital mucous cysts of the finger without osteoarthritis: optimizing outcome of long needle trajectory aspiration and injection. Acta Orthop Belg. 2023;89(2):249-252. doi: 10.52628/89.2.11582.
- Chen C.E., Wang T.H. A Modified Type III Keystone Flap for Digital Mucous Cyst of the Eponychium. Plast Reconstr Surg Glob Open. 2022;10(12):e4715. doi: 10.1097/GOX.0000000000004715.
- Kasdan M.L., Stallings S.P., Leis V.M., Wolens D. Outcome of surgically treated mucous cysts of the hand. J Hand Surg Am. 1994;19(3):504-507. doi: 10.1016/0363-5023(94)90071-X.
- Kanaya K., Wada T., Iba K., Yamashita T. Total dorsal capsulectomy for the treatment of mucous cysts. J Hand Surg Am. 2014;39(6):1063-1067. doi: 10.1016/j.jhsa.2014.03.004.
补充文件
