DORSAL WRIST GANGLION; COMPARATIVE STUDY BETWEEN ASPIRAION PLUS STEROID INJECTION VERSUS SURGICAL EXCISION

Objectives: To evaluate and compare the effect of aspiration plus methyl prednisone injection versus surgical excision of the dorsal wrist ganglions in terms of resolution, complications and recurrence. Study Design: Prospective study. Setting: Surgical ward Hayatabad Medical Complex, Peshawar. Period: June 2009 to December 2011. Methodology: After taking permission from ethical and research committee. Included patients were all adult of both gender with dorsal wrist ganglion. Patients with cancer, bleeding disorders and diabetes were excluded from the study. The patients were divided in two groups: Group A included patients for aspiration and injection treatment, while Group B included patients underwent surgical excision. All the patients were followed for complete resolution of ganglion, any complications of treatment and recurrence within one year. Follow up arranged at 7 th day, 1, 3, 6 and 12 months. Results: Total of 80 patients was included in the study. Out of 80, 65% (n=52) were females while 35% (n=28) were males. The mean age was 26.37±5.62 years. Group A and group B patients had overall success rates of 75% and 95%, with recurrence of 25% and 5% in group A and group B respectively. In methylprednisolone group, mild pain was reported by 70% (n=28), while in the surgical excision group, all the patients experienced mild to moderate pain postoperatively which necessitated oral analgesics for few days. Conclusion: Surgical excision is superior to injection-aspiration method for dorsal wrist ganglion treatment because of high success and low recurrence rate. As injection-aspiration treatment has low morbidity than surgery, it should be reserved for patients not consented for surgery.