Aspiration combined with seton insertion for treatment of wrist ganglions

To evaluate the results of Aspiration combined with Seton insertion in the treatment of wrist Ganglions. Prospective, quasi experimental study from Jan. 2004 to Dec. 2006. Surgical Unit V, Civil Hospital, Karachi. Fifty five patients who presented with wrist Ganglia. All patients were assessed in detail clinically, and treated by aspiration with 14 gauge IV cannula and 10cc syringe followed b Seton [Silk No. 1 on straight needle] insertion through the cavity. Seton was removed on the 12th day. The average follow-up time was one year. Out of 55 patients, 51 [92.7%] had a Dorsal Carpal Ganglion and 4 [7.3%] a Volar Ganglion. Twenty nine [52.7%] cases were males and 26 [47.3%] females, with an age range from 17-35 years. All patients complained of a localized swelling, while 12 [21%] had pain during activity. Fifty two [95%] cases had a smooth recovery, while two had residual swellings requiring re-aspiration and on developed signs of inflammation which subsided on conservative management. No recurrence of the ganglion occurred in any case. Aspiration combined with seton insertion for treating Ganglions of wrist is a simple, economic, cosmetic, uncomplicated procedure which can be done in the out-patient department. It is a reliable and safe alternative to open resection for successful eradication of the wrist Ganglion

Randomized controlled trial between surgery and aspiration combined with methylprednisolone acetate injection plus wrist immobilization in the treatment of dorsal carpal ganglion.

Dorsal carpal ganglion is one of the most common benign tumors of the hand. Many treatment modalities had been proposed and yielded the same success rate. In the present study, the authors conducted a randomized controlled trial to compare the success of treatment between surgery and aspiration combined with methylprednisolone acetate injection plus wrist immobilization. There were 28 patients enrolled and randomized into two treatment groups. Only 24 patients were available for the final follow up at 6 months. According to the present study, dorsal carpal ganglion was more common in females (83.3%) at an average age of 30 years. Pain was the most common presenting symptom (58.3%). The success by excision was 81.8% and by aspiration combined with methylprednisolone acetate injection plus wrist immobilization was 38.46%. The p-value was 0.047 by Fisher exact test. The present study has clearly shown that surgical excision gave a better success rate in the treatment of dorsal carpal ganglion.