Swelling on the dorsal aspect of the finger over the DIP joint
Cause
Usually there is a degree of osteoarthritis in the end joint of the finger. A cyst forms between the extensor tendon and the side ligament, causing a soft tissue swelling, which can be felt and usually seen over the back of the hand.
Diagnosis
The location and appearance of the swelling is usually diagnostic
X-rays can be performed showing degenerative joint.
The cyst sometimes causes a pressure groove on the nail plate, causing a nail deformity.
Occasionally an MRI scan or ultrasound will confirm the diagnosis.
Treatment
Occasionally the cysts will rupture and heal by themselves, not requiring treatment
Surgical Treatment – either general or regional anaesthetic
The skin is opened up through an ‘H’ type incision on the back of the finger. The cyst is debrided from the degenerative DIP joint. Bony spurs are nibbled back.
If the joint is grossly arthritic and painful then a fusion procedure is normally performed.
Potential Complications
Infection, haematoma, wound breakdown
Stiffness to the DI P joint
Recurrence of the Cyst
Post Op Care
The patient is usually in a finger dressing post operatively
Occasionally a splint is used to protect the extensor tendon
Specialist review at ten days for wound inspection and stitch removal and at six weeks for clinical review and three months.
