THE D ISTRIBUT ION OF F IBROUS FLEXOR SHEATH GANGLIONS

The distribution of fibrous flexor sheath ganglions was studied in 57 patients. They were found to be more common in the third decade and in the middle finger. Both hands were equally affected. There was no clear relationship to occupation or repeated trauma. The striking finding in our study was the male predominance. Journal of Hand Surgery (British and European Volume, 1997) 22B. " 2:226-227 Simple ganglions account for about two-thirds of all hand tumours (Stack, 1964). In previous eries of gang-lions in the hand, between 5 and 16 % arose from the fibrous flexor sheath (Carp and Stout, 1928; Hvid-Hansen, 1970; McEvedy, 1962). Matthews (1973) reported the first exclusive series of fibrous flexor sheath ganglions (FFSGs). The pathological features of FFSGs are identical to ganglions occurring elsewhere (Lawson et al, 1994). Ganglions in general are more common in women with the F: M ratio nearly 3: 1 (Carp and Stout, 1928; Hvid-Hansen, 1970; McEvedy, 1962). FFSGs have been reported to show the same female predominance (Matthews, 1973). FFSGs occur most commonly in the middle finger, and Matthews noted that around 25 % of his patients did secretarial work. We have studied the distribution of FFSGs to see if there was a similar occupational link in our patients. MATERIALS AND METHODS All case notes of 57 patients diagnosed, on the bases of clinical presentation and treatment, as having FFSGs were studied. The information from the notes included age, sex, site of ganglion, occupation, type of treatment, recurrence and hand dominance. five were lorry drivers and only three were typists. The rest had non-manual jobs. Treatment and number of recurrences are given in Table 2. DISCUSSION This study confirms the predominance of the middle finger as the site of FFSGs, and the equal distribution between right and left hands reported by Matthew