Flexor sheath ganglion

A small, firm ganglion arising from the flexor tendon sheath of a finger, usually at the A1 or A2 pulley near the base of the digit. It feels like a pea, is tender when gripping, and lies between the digital neurovascular bundles. It often recurs after puncture and rarely after excision with a small window of the sheath.

Related terms

• Condition

  Ganglion cyst

  A benign cyst filled with thick, clear mucin and joined by a stalk to a nearby joint capsule or tendon sheath; its wall has no true synovial lining. It is the commonest lump of the hand and wrist and arises most often on the back of the wrist over the scapholunate ligament, on the front of the wrist beside the radial artery, from a finger's flexor tendon sheath, or as a mucous cyst at the end joint. About half resolve without treatment.

• Anatomy

  A1 pulley

  The first of the fibrous bands (pulleys) that hold the flexor tendons against the finger bones, lying at the base of the finger over the metacarpophalangeal joint. It is the band that thickens in trigger finger and is divided in a trigger finger release; the A2 and A4 pulleys are the ones that must be preserved.

• Anatomy

  Digital neurovascular bundle

  Bundle containing the proper digital artery, proper digital nerve, and accompanying veins, running along the radial and ulnar aspects of each finger, deep to Grayson's ligament and superficial to Cleland's ligament. Its position is normally predictable but is displaced by the spiral cord in Dupuytren's disease.

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