Abstract
Aim: To assess the long-term treatment outcome following conservative treatment of wrist ganglions by aspiration and steroid injections.
Materials and Methods: Between December 2001 and November 2003, 49 patients with wrist ganglions were seen and treated by one surgeon*. There were 20 males and 29 females with an average age of 37 years (range 13 to 70 years). Anatomically we had 41 dorsal wrist, 5 volar wrist and 3 digital ganglions. Diagnosis was made on clinical examination, explained to patients about the condition and given three options of treatment.
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Reassurance,
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Aspiration and steroid injection and
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Surgery with its associated complications.
39% (14) were satisfied with reassurance alone, 69%(34) had aspiration and steroid injection and one opted for surgery.
Those who opted for aspiration and steroid injection are included in the study.
The aspiration was carried out under sterile technique, area infiltrated with 1% lignocaine, followed by aspiration of ganglion content using 16 G needle and injection of Methyl-prednisolone Acetate BP 40 mg/ml. The patients were advised to carry out their normal activities and followed up at 6 weeks, 3 months and 6 months.
Follow up period range between 6 weeks to 6 months (average of 3.8 months).
Results: 34 ganglia treated with aspiration and steroid injection had a cure rate of 47%(16), 31%(10) and 12%(4) respectively after 1,2 and 3 treatments with a cumulative success rate of 88%(30 of 34). We had recurrence rate of 12% (4 of 34) after 3 injections and two patients with skin discoloration.
Conclusion: Treatment options should be given to patients with wrist and digital ganglions. Conservative treatment is quite successful, which will avoid surgery and associated complications. Even though our sample size is too small to make any statistical significance, cumulative success rate of 88% following multiple treatments of aspiration and steroid injections are in comparable with other studies.
Honorary Secretary Mr Bimal Singh. Correspondence should be addressed to BOSA (British Orthopaedic Specialists Association), c/o Royal College of Surgeons, 35 – 43 Lincoln’s Inn Fields, London WC2A 3PE.
