What is a a cyst cyst ?
It’s a rounded formation containing a liquid with an oily texture. The cyst is perceived as a small “bump” at the base of the finger. Its size can vary from 1 to 8 millimeters in diameter. Its origin is generally linked to repeated mild trauma to the base of the finger. These cysts form from deterioration of the collagen fibers that make up the flexor tendon sheath. This deterioration creates an opening through which synovial fluid escapes from the sheath. This fluid is then enveloped by a fibrous envelope that forms the cyst.
When intervention is necessary ?
These cysts are completely harmless. Surgery is considered when these cysts cause discomfort through pain to the touch, difficulty in certain finger grasping movements, or an unattractive appearance. There is never an urgent need to remove a tenosynovial cyst, as it can eventually disappear spontaneously, without the need for treatment. Surgery is recommended only when the impact on functionality is significant.
Procedure
The most commonly used anesthetic is locoregional. Surgical technique: the incision is made on the palm side, in line with the cyst. The cyst is removed in one piece: the surgeon removes the cyst without piercing it, and removes a small portion of the flexor tendon sheath around the base of the cyst. To perform this excision, the vessels and collateral nerves on either side of the cyst will have to be displaced. However, their displacement can lead to nerve irritation after the operation, manifested by tingling sensations (paresthesias) at the fingertip. More serious damage to these vascular and nerve structures is rare. Post-procedure recovery is generally straightforward. Immediately after the anaesthetic wears off, it’s important to mobilize the fingers quickly, bending and stretching them to prevent the tendon sheath sticking to the incision site. Self-education is often sufficient, but temporary stiffness may sometimes require additional re-education. Forced movement will only be permitted after around two weeks. The scar may remain swollen and sensitive for several weeks. The length of time off work will depend on your professional activity. Recurrences after this procedure are extremely rare.
Your intervention in practice
Before the procedure, we recommend that you attend a pre-anesthesia consultation and carefully follow the skin preparation instructions provided. Hospitalization for this procedure is generally on an outpatient basis, which means you will be allowed to return home the same day. It is imperative that you bring a car to accompany you home after the procedure, as you will not be able to drive when you leave the medical facility. In the days following the operation, it is important to avoid wetting the dressing covering the operated area. It is also advisable to keep the hand slightly elevated from the elbow for at least 12 hours, to reduce the risk of swelling. Initial dressing changes must be carried out by a nurse. If you have any doubts or questions, please contact the surgical department for answers and advice.
