Outcome of treatment of pedal ganglia

Between 1st March 1995 and 31st December 2002 we treated 70 patients for pedal ganglia. Review was in research clinic or by postal questionnaire by an independent reviewer. One patient had died of unrelated causes and one was housebound and frail. Twenty-one were lost to follow-up.Seventeen patients had no intervention. Only one subsequently underwent surgical removal of the ganglion. Nine patients had a ganglion at review (including the patient operated on). However, only four had symptoms, all minor, and none wished further intervention. Eight of the 16 untreated ganglia had resolved (50%).Thirteen patients had simple aspiration, mainly of small ganglia. Six repeat aspirations and three surgical excisions were carried out for symptomatic recurrence. At review, nine had ganglia. Five had minor symptoms but none wished further treatment.Fourteen patients had aspiration and steroid injection, mainly of larger ganglia. Five repeat aspirations and six surgical excisions were carried out for recurrence. Six patients had ganglia present at review. Six patients in the group had minor residual symptoms but none wished further intervention.In all, 13 patients underwent excision of ganglia. Eight recurred and three patients underwent repeat excisions. Ganglia were present in five patients at review. None of the patients wished further intervention. There were five minor wound problems but no infections or major nerve injuries.Only 23% of our patients required surgery. Although many had residual or recurrent ganglia at follow-up, most had few or no symptoms. Observation or aspiration, with or without steroid injection, is satisfactory for most patients with pedal ganglia.