Vol. 2 No. 02 (2018)
Original Article

The Outcome of Intralesional Steroid Injection for Ganglion Cyst compared to surgery

Full Article

HTML PDF
Khwaja H Salim
Assistant Professor, (Pediatric Surgery), Shaheed Tazuddin Ahmad Medical College, Gazipur
Zobaer Hassan Chowdhury
Assistant Professor (Pediatric Surgery), Sheikh Sayera Khatun Medical College, Gopalganj
Shams E Tabriz
Associate Professor (Anatomy), Sheikh Sayera Khatun Medical College, Gopalganj
Md. Humayun Kabir
Associate Professor (Ortho Surgery), Sheikh Sayera Khatun Medical College, Gopalgonj

Find this Article on:

Abstract

Background: Ganglia are the most common benign cystic swellings found over both the dorsal and volar aspects of the wrist. In spite of technical advancement, both operative and non-operative interventions achieve more or less similar results. Complete evacuation of gelatinous fluid followed by intralesional injection of Triamcinolone gives encouraging results. This study was done to explore the outcome of intralesional steroid injection compared to surgery for the management of ganglion cyst. Materials and Methods: A prospective study was conducted on patients with simple ganglion cysts on the wrist. Total of 100 patients underwent this study. Out of this, 45 patients underwent aspiration of the cyst fluid followed by intracystic instillation of triamcinolone, and 55 patients underwent surgical excision of wrist ganglia. Two years follow up was done for evaluation of outcome. Result: Most ganglia of wrist occurred in the extensor aspect. Complications noted among the surgically excised group were post operative pain and restricted mobility of wrist with a recurrence rate of 21.5%. Instillation of triamcinolone into the ganglion yielded early resolution with a low recurrence rate of 8.4%. Conclusion: Recurrence is the most common complication of management of ganglion cyst & its incidence is less following intralesional triamcinolone injection compared to surgical excision.

Downloads

Download data is not yet available.

References

  1. Plate AM, Lee SJ, Steiner G, Posner MA. Tumor like lesions and benign tumors of the hand and wrist. J Am Acad Orthop Surg. 2003;11:129–41.
  2. Thornburg LE. Ganglions lesions of the hand and wrist. J Am Acad Orthop Surg. 1999;7: 231–8.
  3. Angelides AC, Wallace PF. The dorsal ganglion of the wrist: Its pathogenesis, gross and microscopic anatomy, and surgical treatment. J Hand Surg. 1976;1:228–35.
  4. Nahra ME, Bucchieri JS. Ganglion cysts and other tumor related conditions of the hand and wrist. Hand Clin. 2004;20:249–60.
  5. Wang G, Jacobson JA, Feng FY, Girish G, Caoili EM, Brandon C. Sonography of wrist ganglion cysts: Variable and noncystic appearances. J Ultrasound
  6. Med. 2007;26:1323–8.
  7. Zubowicz VN, Ischii CH. Management of ganglion cysts of the hand by simple aspiration. J Hand Surg. 1987;12:618–20.
  8. Clay NR, Clement DA. The treatment of dorsal wrist ganglia by radical excision. J Hand Surg. 1988;13:187–91.
  9. Edwards SG, Joansen JA. Prospective outcomes and associations of wrist ganglion cysts resected arthroscopically. J Hand Surg Am. 2009;34: 395–400.
  10. Rocchi L, Canal A, Fanfani F, Catalano F. Articular ganglia of the volar aspect of the wrist: Arthroscopic resection compared with open excision: A prospective randomised study. Scand J Plast Reconstr Surg Hand Surg. 2008;42:253–9.
  11. Mehdian H, McKee MD. Scapholunate instability following dorsal wrist ganglion excision. Iowa Orthop J. 2005;25:203–6.
  12. Duncan KH, Lewis RC. Scapholunate instability following ganglion cyst excision: A case report. Clin Orthop Relat Res. 1988;228:250–3.
  13. Nishikawa S, Toh S, Miura K, Arai K, Irie T. Arthroscopic diagnosis and treatment of dorsal wrist ganglion. J Hand Surg. 2001;26:547–9.
  14. Rizzo M, Berger RA, Steinmann SP, Bishop AT. Arthroscopic resection in the management of dorsal wrist ganglions: Results with a minimum 2-year followup period. J Hand Surg Am. 2004;29:59–62.
  15. Neidoff M, Davis TRC, Clay NR. Conservative management of wrist ganglia: Aspiration versus steroid infiltration. J Hand Surg. 1997;22:636–7.
  16. Colberg RE, Sánchez CF, Lugo-Vicente H. Aspiration and triamcinolone acetonide injection of wrist synovial cysts in children. J Pediatr Surg. 2008;43:2087–90.
  17. Paramhans D, Nayak D, Mathur RK, Kushwah K. Double Dart Technique of Instillation of Triamcinolone in Ganglion Over the Wrist. J Cutan Aesthet Surg.
  18. Jan-Apr; 3(1): 29–31
  19. Jagers M, Akkerhuis P, van Der Heijden M, Brink PRG. Hyaluronidase versus surgical excision of ganglia: a prospective, randomized clinical trial. J
  20. Hand Surg.2002;27:256–8. 18. Paul AS, Sochart DH. Improving the results of ganglion aspiration by the use of hyaluronidase. J Hand Surg. 1997;22:219–21.

Published 21-09-2021

Keywords

  • Ganglion cyst,
  • triamcinolone,
  • intralesional injection

How to Cite

1.
Salim KH, Chowdhury ZH, Tabriz SE, Kabir MH. The Outcome of Intralesional Steroid Injection for Ganglion Cyst compared to surgery. Planet (Barisal) [Internet]. 2021 Sep. 21 [cited 2024 Jul. 3];2(02):5. Available from: https://bdjournals.org/index.php/planet/article/view/51