Total Dorsal Capsulectomy for the Treatment of Mucous Cysts

PurposeTo describe the technique of total dorsal capsulectomy alone for mucous cysts of the distal interphalangeal (DIP) joint and evaluate its outcomes and complications.MethodsNineteen patients (18 women and 1 man) with 19 mucous cysts were treated by a total dorsal capsulectomy without cyst excision or osteophyte removal. The average age at surgery was 63 years. The thumb was involved in 4 patients, index finger in 1, middle finger in 7, ring finger in 4, and little finger in 3. Twelve patients had nail deformities associated with the mucous cyst. The average period of postoperative follow-up was 26 months. The dorsal half of the DIP joint capsule was resected with a punch and curette. The cyst and osteophytes were left intact.ResultsThe average preoperative range of motion for the DIP joint was from 10° of extension to 45° of flexion. Radiographs showed osteophytes at the DIP joint in all affected digits. After surgery, all cysts disappeared at an average of 3 weeks. There was no recurrence at the time of final follow-up. All nail deformities had resolved at an average of 5 months after surgery. The average motion for the DIP joint at the time of final follow-up was from 8° of extension to 56° of flexion. There were no acquired nail deformities or other complications.ConclusionsA total dorsal capsulectomy alone was a simple treatment for mucous cysts and did not lead to any recurrence.Type of study/level of evidenceTherapeutic IV.