(Disclaimer: This article is for general use only, and the information in the following content has been processed to protect patient privacy)
Abstract: The patient is a 26-year-old female, 5 years ago found left wrist mass, size of about 0.5cm × 1cm, not timely treatment, in recent years the mass gradually increased, and pain symptoms, so came to our hospital, perfect ultrasound and other examinations, preliminary consideration for tendon sheath cyst, given left wrist tendon sheath cyst excision, the operation was smooth, postoperative drug symptomatic treatment, postoperative mass removal, wound healing, treatment results The result was good.
Basic information】Female, 26 years old
Type of disease】Tendon sheath cyst
Hospital】The First Affiliated Hospital of Xi’an Jiaotong University
Date of Consultation】October 2015
Treatment plan】Surgery (left wrist tendon sheath cyst removal) + medication (cefuroxime sodium for injection, flurbiprofen ester injection)
Treatment period】3 days of inpatient treatment, 10 days of outpatient medication change, regular review
Treatment effect] The mass was removed, the wound healed, and the treatment effect was good.
I. Initial consultation
The patient, female, 26 years old, found a mass on her left wrist 5 years ago, about 0.5cm×1cm in size, without pain, numbness and other discomfort, and did not give special treatment. In recent years, the mass gradually increased in size, and painful symptoms appeared. The patient came to our hospital for further treatment. Ultrasound examination showed that the left wrist mass was about 1cm×2cm in size with clear border, which was considered as tendon sheath cyst.
II. Treatment history
After admission, routine electrocardiogram, routine blood, liver and kidney function, electrolytes, coagulation and other tests were completed, and there was no obvious contraindication to surgery. After the operation, cefuroxime sodium for injection was given as anti-infection and flurbiprofen ester injection as pain relief. Postoperative pathological examination suggested that the gray-white and gray-pink tissue, the gray-white area was cystic, the content of transparent mucus, the wall thickness was 0.1 cm, the wall of the cyst was smooth both inside and outside, the gray-pink area was solid, another gray-pink tissue was seen in the mass, the texture was medium and soft, it was a tendon sheath cyst. Postoperatively, the patient was advised to review regularly.
(Pathology report)
III. Treatment results
The patient underwent resection of the left wrist tendon sheath cyst under local anesthesia. The patient’s symptoms improved after complete resection by careful operation to avoid injury to important blood vessels and nerves. After changing the medication on the 3rd postoperative day, the wound healed well and the pain symptoms were significantly reduced. No postoperative infection occurred, and the patient was discharged from the hospital and advised to change the medication every 3 days after discharge until about 10 days. The patient was discharged and advised to change the medication every 3 days until about 10 days after discharge. One year after discharge, the appearance was normal and no recurrence was seen in the ultrasound.
IV. Notes
We are glad that the patient gradually recovered from the tendon sheath cyst, but we need to advise the patient to pay attention to the local recurrence during the follow-up visit after discharge, and if recurrence should be detected and given treatment in time. There is generally no absolute contraindication in terms of diet in daily life, and a healthy diet according to dietary habits, such as high protein and nutritious diet, can be followed. Avoid excessive use of the wrist joint in life or work, such as long-term typing and other repetitive movements, to prevent recurrence.
V. Personal insight
Tendon sheath cyst is a common orthopedic disease, mainly found in the tendon sheath at the joint, mainly due to connective tissue degeneration. Tendon sheath cyst is a disease with high incidence, and most people have some knowledge about it. Some patients are treated by puncture and aspiration followed by pressure bandaging, which is less invasive but more likely to recur because the cyst wall still exists. The cyst wall is removed as completely as possible during surgical excision to prevent its recurrence. In this case, the diagnosis and treatment were accurate and the surgery was performed with local anesthesia, which was less traumatic and resulted in quick recovery. Postoperative care is needed mainly to avoid prolonged incorrect use of the wrist joint.