Management of Wrist Ganglion by Aspiration and Triamcinolone Injection Versus Surgical Excision of the Cyst

Abstract

INTRODUCTIONGanglion cysts are commonly occurring lumps of the hand usually found on palmer or dorsal surface of wrist and palmer surface of the base of fingers. They are idiopathic in origin but can be caused by trauma. Ganglion cysts disappear spontaneously, hence, in most cases they are only observed. However, if they persist, become painful or limit activity several treatment options are available.

OBJECTIVE To assess recurrence rate of ganglion cyst following aspiration and injecting triamcinolone into the cyst and surgical excision of the cyst.

DESIGNThis is a prospective comparative study

PLACE AND DURATION OF STUDY This study was carried out in Surgical Unit of Fauji Foundation Hospital Lahore and Mohsin Medical Complex Walton Lahore for a period of time from February 2018 to March 2020.

RESULTS This study was carried out in 50 patients, results were obtained and compared. Two groups were formed Group A and Group B, with 25 patients in each group. It showed that 21 patients (84%) of the Group A who were managed with aspiration and triamcinolone injection had recurrence of the ganglion cyst and patients expressed dissatisfaction. In Group B all 25 patients had surgical excision of the ganglion with only 3 patients (12%) having recurrence.

CONCLUSION It was concluded that aspiration and injecting triamcinolone into ganglion cyst is a simple procedure that can be performed inside the doctor’s office. It gives quick relief without requiring patient preparation or post-surgical complications. However, it is an ineffective management of ganglion cyst. Whereas, surgical excision showed better results. Patients expressed satisfaction despite the surgical trauma and discomfort of 1-day hospital stay.