Ganglion of the Flexor Tendon Sheath between A1 Pulley and A2 Pulley

Jung,  Kyu Hwa; Choi,  Hwan Jun; Kim,  Jun Hyuk

doi:2014.23.1.29

Arch Hand Microsurg > Volume 23(1); 2014 > Article

Case Report

Archives of Hand and Microsurgery 2014;23(1):29-32.
Published online May 30, 2014.
DOI: https://doi.org/10.15596/ARMS.2014.23.1.29

Ganglion of the Flexor Tendon Sheath between A1 Pulley and A2 Pulley

Kyu Hwa Jung, Hwan Jun Choi, Jun Hyuk Kim

Department of Plastic and Reconstructive Surgery, Soonchunhyang University College of Medicine, Cheonan, Korea. medi619@hanmail.net

Received: 14 February 2014 • Revised: 5 May 2014 • Accepted: 21 April 2014

Abstract

Few articles have been written about the flexor tendon sheath ganglion in the finger, especially, between A1 pulley and A2 pulley. We report on rare cases of flexor tendon sheath ganglion with one symptomatic and two asymptomatic. All masses were evaluated using real-time ultrasonography and well-defined anechoic cystic lesions with posterior enhancement were observed. A 17-year-old female had a small mass at the 4th metacarpophalageal joint of her right hand, with pain and triggering. The patient underwent simple excision and a ganglion measuring 1.0×0.8 cm in size was derived from Camper’s chiasm, between A1 pulley and A2 pulley. In two asymptomatic cases, ganglia measuring less than 0.5 cm in size observed. Based on our experience, real-time ultrasonography would be an excellent diagnostic modality in determining the treatment method in flexor tendon sheath ganglia, and surgical excision is recommended in symptomatic, especially triggering patients.

Key Words: Hand, Tendons, Ganglion cyst, Ultrasonography