Intraosseous Ganglion Spanning the Scaphoid and Lunate: A Case Report

TL;DR

A rare case of a bone cyst spanning two wrist bones was successfully treated with surgery, leading to significant pain relief and improved wrist stability.

Contribution

Reports a rare intraosseous ganglion spanning the scaphoid and lunate, with successful surgical treatment and long-term follow-up.

Findings

Surgical curettage and joint fixation improved wrist pain and instability.

Two years post-surgery, no carpal bone collapse or defect expansion was observed.

Bone formation occurred in the treated scaphoid area.

Abstract

Intraosseous ganglions (IOGs) are actually quite common but one spanning two adjacent carpal bones is uncommon. We report a case with an IOG spanning the scaphoid and lunate, which was treated surgically. A 16-year-old right-handed female noticed left wrist pain that started spontaneously five years previously. Physical findings indicated carpal instability in the left wrist. Posteroanterior radiographs of the left wrist showed small cysts in the lunate and scaphoid, while the lateral radiograph revealed volar flexion of the lunate. Bone curettage was performed using sharp curettes, and due to the physical findings of carpal instability, temporary scapho-trapezoidal joint fixation was done using two Kirchner wires. Two years post-surgery, wrist pain had significantly improved and carpal instability findings disappeared. Computed tomography revealed no obvious collapse of carpal bones and expansion of bone defects in the lunate and scaphoid. Bone formation was observed in the bone curettage area of the scaphoid.

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