ABSTRACT
There are several types of treatment modalities for wrist ganglions. The aim of the study was to assess the effectiveness of cyst aspiration and methyl prednisolone acetate injection with double IV cannula rather than sharp pointed needle, as a new technique in the treatment of volar ganglia. The study involves total of 19 patients who received treatment by aspiration and methyl prednisolone injection into the cavity. Two IV cannulas are pricked to the cystic cavity. Cyst fluid is drained by the distally placed IV cannula meanwhile injecting methyl prednisolone by proximally placed IV cannula. The patient records and follow-up reports are retrospectively investigated. The patient age, sex, site of the cyst, the treatment that was applied, adjacency to the artery and the nerves and recurrence are recorded. Mean follow up time was 2.1 +/- 0.5 years. The study involved 19 patients that received aspiration treatment for volar ganglion cysts between January 2004 and December 2009. There were 12 [63.2%] female and 7 [36.8%] male subject with volar wrist ganglion cyst. The mean age of patients was 27.63 +/- 6.6 years. Fourteen [73.7%] patients of total had cysts close to the artery. We didn't observe any complication related to methyl prednisolone injection and arterial ischemia. Recurrence was observed in three [15.8%] patients. This method has lower recurrence rate than other aspiration therapy with sharp pointed needle. We prefer to use IV cannula needle for cyst aspiration and steroid injection in treatment of volar ganglia before any surgical intervention
Subject(s)
Humans , Male , Female , Wrist , Palmar Plate , Suction , Methylprednisolone , CathetersABSTRACT
To evaluate the effectiveness of mini-transverse compared with mini-longitudinal incision for carpal tunnel release [CTR] with reference to postoperative functional capacity, symptom severity and complication rate. Analytical study. Cumhuriyet University Medical Faculty, Department of Orthopaedics, Tokat State Hospital, Department of Orthopaedics and Medical Park Tokat Hospital, Department of Neurosurgery, from January 2007 to January 2009. This study included 93 hands of 79 patients with carpal tunnel syndrome [CTS], which were operated between 2007 and 2009. Patients were divided according to incision types into Group-1 [undergoing mini-longitudinal incision] and Group-2 [undergoing mini-transverse incision]. Patients were evaluated initially and at 3 weeks after treatment according to symptom severity and functional status of Boston Questionnaire [BQ]. Demographic and clinical data were analyzed and compared statistically between two groups. Statistically significant differences were observed in BQ symptom and functional scores between the pre- and postoperative period [p < 0.0001]. BQ symptom and functional scores at postoperative period were better in Group-1 than Group-2 [p = 0.044 and p = 0.023 respectively]. The scar hypersensitivity [p = 0.258] and tenderness [p = 1.00] associated with the incision sites were not statistically different. Longitudinal incision is more effective on symptom and functional conditions than transverse incision. However, there was less scar formation with transverse incision
ABSTRACT
The goal of this study was to evaluate outcome of patients with pigmented villonodular synovitis [PVNS] managed by Yttrium90 [90Y] after debulking surgery. Seven patients [3 males and 4 females] with PVNS were studied retrospectively. Mean follow-up was 47.8 months [range 24-97 months]. Mean age was 44.8 years [range 20-68 years. Debulking surgeries via arthroscopic synovectomy were performed in 4 cases and in 3 cases via mini arthrotomy. After 90Y injection was applied. Magnetic resonance imaging [MRI] included measurement of synovial thickness in preoperative and at last control. Main musculoskeletal tumor society score was 26 [range, 23-29], main MTS rating was 70.4% [range, 38.5-86.2%]. Mean preoperative synovial thickness was 14.9mm range 20-12mm. Synovial thickness was completely disappeared at last MRI examination. There was diffuse joint effusion preoperatively, decreasing at last control. No cases of PVNS recurrence were found. Although we had a small number of cases, we believe that combination of debulking surgery with intra-articular injection of 90Y for PVNS of knee joint is an effective and safe treatment method