These are examples
of a technique for mucous cyst excision using a longitudinal eponychial
splitting incision I learned from Damien Ireland. Mucous cysts arise from the dorsal DIP joint capsule, often associated with small dorsal osteophytes of the distal phalanx. The cyst itself is a secondary effect and needs no treatment.
Joint debridement addresses the source of the problem.
- Leave the cyst itself undisturbed
- Use a longitudinal incision and elevate a flap superficial to the extensor
mechanism
- Excise the dorsal hemicircumference of the joint capsule.
- Use a 2mm Kerrison punch to debride osteophytes proximal to the terminal tendon insertion
- Close the deep eponychial surface with a pullout suture and then close with a simple running suture.
|