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      Comparison of Aspiration Followed by Intra-Lesional Steroid Injection and Surgical Excision in Management of Dorsal Wrist Ganglion

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          Abstract

          BACKGROUND

          About 60-70% of ganglion cysts are found in dorsal part of the wrist. This study compared aspiration followed by intra-lesional steroid (triamcinolone acetate) injection and surgical excision in the management of dorsal wrist ganglion.

          METHODS

          From Aug 2016 to Aug 2018 in Department of General Surgery, Government Medical College Srinagar, India, 86 Patients with dorsal wrist ganglions were enrolled. The patients were divided to two groups undergoing two different treatment modalities including 68 patients of aspiration with intralesional triamcinolone acetonide injected into the cyst (group A) and 18 patients with surgical excision (group B). Follow up time was 1, 3, 6 and 12 months.

          RESULTS

          Successful treatment was noticed in 59 patients of group A (86.8%), and in 15 patients of group B (83.3%).

          CONCLUSION

          Aspiration followed by intra-lesional steroid injection was better managed in comparison to surgical excision.

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          Most cited references15

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          Ganglion cysts of the wrist: pathophysiology, clinical picture, and management

          Warren Gude, Vincent Morelli (2008)
          This article reviews what is known about ganglion cyst formation, natural history (50% of cysts will spontaneously resolve), diagnosis, and management of this common malady. Although the exact mechanism of cyst formation is unknown, most current theories hold that extra-articular mucin “droplets” coalesce to form the main body of the tumor. Only subsequently are the “cyst wall” and pedicle (connecting the cyst to a nearby synovial joint) formed. Treatment options include watchful waiting, nonoperative aspiration/injection, and surgical removal. Although treatment is often unnecessary, many patients seeking consultation desire some form of definitive treatment. Cyst aspiration/injection is fraught with a high incidence of recurrence. Surgery generally results in lower rates of recurrence, but a higher incidence of complications. All current treatment options are suboptimal.
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            Cancer occurrence in Fars province, southern Iran

            D Mehrabani, SZ Tabei, ST Heydari … (2008)
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              Improving the results of ganglion aspiration by the use of hyaluronidase.

              A Paul, D Sochart (1997)
              We present the results of a prospective randomized trial comparing the treatment of ganglia by aspiration under local anaesthetic and either instillation of steroid alone or with the prior use of hyaluronidase. Thirty-five patients were treated in each group and followed up for 2 years. The cure rate with the combined use of hyaluronidase and methylprednisolone was 89%, compared to 57% when treated by aspiration and instillation of methylprednisolone alone.
              Article 0 comments Cited 4 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): World J Plast Surg
                Journal ID (iso-abbrev): World J Plast Surg
                Journal ID (publisher-id): WJPS
                Title: World Journal of Plastic Surgery
                Publisher: Iranian Society for Plastic Surgeons (Tehran, Iran )
                ISSN (Print): 2228-7914
                ISSN (Electronic): 2252-0724
                Publication date (Print): May 2019
                Volume: 8
                Issue: 2
                Pages: 181-184
                Affiliations
                [1]Department of General Surgery, GMC Srinagar, Jammu and Kashmir, 190010, India
                Author notes
                [* ]Corresponding Author: Ajaz Ahmad Shah, Senior Resident, Department of General Surgery, GMC Srinagar, Jammu and Kashmir, 190010, India. Email: ajazshah17@gmail.com
                Article
                DOI: 10.29252/wjps.8.2.181
                PMC ID: 6620806
                SO-VID: 72bf9c95-4ae5-4453-9451-36f369d20f4b
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 17 February 2018
                Date revision received : 12 January 2019
                Date accepted : 20 January 2019
                Categories
                Subject: Original Article

                Keywords: aspiration,intra-lesional,steroid; surgery,excision,dorsal wrist ganglion
                Data availability:
                Keywords: aspiration, intra-lesional, steroid; surgery, excision, dorsal wrist ganglion

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