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Hygroma

A hygroma is a tumor-like benign single formation accumulating liquid with fibrin and mucus. It is usually found in the serous bursa. The main factor is considered to be frequent traumas or high physical loads, but this fact is quite controversial and understudied. The treatment tactics depends on the size of the formation. If it is rather small, conservative treatment is likely. If it turns ineffective, surgical treatment is inevitable. 

Clinical symptoms

The new formation is slowly growing and at first it doesn’t bother you. Its usual localization is the ankle joint or it can form on the back side of metatarsophalangeal bones. 
The skin over the tumor gets thicker and rougher and sometimes it reddens. 
At first it is painless but afterwards an acute pain can appear by pressing or at motion. If neglected the hygroma can grow really big which can cause compression of the adjacent vessels and nerves and a strong pain which increases because of uncomfortable footwear or physical activity. 

Diagnostics

A hygroma can be diagnosed by an orthopedist or surgeon by means of palpation. By examination a small round soft elastic induration of the 1 – 5 cm diameter with a smooth surface can be found. If necessary, the doctor prescribes additional and instrumental methods of examination such as roentgenography of joints. 

Conservative treatment

  • К Conservative treatment includes puncturing which is used for healing or diagnostic purposes. The induration is pierced by means of a puncture needle and its content is pumped out. Then the cleared cavity is filled with sclerosing agents and compressing bandage is attached. 
  • The extremity is immobilized with an orthopedic fixation device or plaster bandage for 7-8 days which prevents the tendon (or injured joint) from functioning thus reducing the production of synovial liquid. The major disadvantage of this method is a big number of exacerbations. 
  • If necessary physiotherapy (UV treatment) or paraffin applications are prescribed.

Surgical treatment methods

  • Incision of the hygroma. This method is considered effective for treating hygromas. It implies complete incision of the compressed capsule not dispersing the tissue but cutting it down and further stitching to the subcutaneous tissue of the stump. The advantage is a lesser number of exacerbations in comparison with other methods. 
  • The laser method implies laser heating of the tumor till it disappears completely; the adjacent tissues are not affected. Such an operation reduces the restoration period and its main advantage is that no scars or cicatrixes are left.
The indications are the fast growth, big size of the new formation, a cosmetic defect, complications (purulence, inflammation, edema, reddening or intense pain). By surgical removal of the induration all operations are performed under local anesthesia which excludes any painful sensations.

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