Official publication of Rawalpindi Medical University
To Compare Thread Technique Versus Aspiration Plus Steroid Injection Of Wrist Ganglion In Terms Of Frequency Of Recurrence

Supplementary Files

PDF

How to Cite

1.
Basit A, Abbasi SH, Farooq M, Shah FH. To Compare Thread Technique Versus Aspiration Plus Steroid Injection Of Wrist Ganglion In Terms Of Frequency Of Recurrence. JRMC [Internet]. 2025 Mar. 29 [cited 2025 Apr. 24];29(1). Available from: https://journalrmc.com/index.php/JRMC/article/view/1678

Abstract

Objective: To compare the recurrence of wrist ganglion following thread technique versus aspiration plus steroid injection.

Methods: This was a  Randomized controlled trial conducted in the  Department of Surgery. HIT Hospital, Taxila from June 2020 to December 2020. Sixty patients were randomized into two equal groups A and B after clinical diagnosis of wrist ganglion. Informed written consent was obtained after informing all pros and cons of the procedure. The thread technique was done in group A while in group B methyl prednisolone acetate 40 mg/ml was injected after aspiration. The patients were followed 2 weeks, 6 weeks, 3 months, and 6 months. The clinical examination was done to see the possible recurrence.

Results: The mean age of the participants was 29.30 ± 6.0 years. The mean duration of ganglia was 19.33 ± 8.35 months. The location of ganglia was 37 (61.7%) dorsal and 23 (38.3%) volar. The male-to-female ratio was 22 (36.7%): 38 (63.3%). Collectively, the frequency of recurrence was 6 (10%), 10 (16.7%), 12 (20%) and 16 (26.7%) at 2 weeks, 6 weeks, 3 months, and 8 months respectively. There was no difference between groups A and B in terms of age, gender, location, and duration of disease (p values 0.401, 0.592, 0.791, 0.783 respectively). The frequency of recurrence was significantly different among groups at 6 months i.e. 12 (40.0%) in group A versus 4 (13.3%) in group B (p-value 0.020).

Conclusion: The thread technique of wrist ganglia is superior to steroid injection in terms of recurrence. The RCTs with a larger sample size and prolonged follow-up would provide more insight into this subject.

https://doi.org/10.37939/jrmc.v29i1.1678

References

Federer AE, Yoo M, Stephens AS, Nelson RE, Steadman JN, Tyser AR, et al. Minimizing Costs for Dorsal Wrist Ganglion Treatment: A Cost-Minimization Analysis. J Hand Surg Am. 2023;48(1):9-18 10.1016/j.jhsa.2022.09.002: http://doi.org/[10.1016/j.jhsa.2022.09.002

Gregush RE, Habusta SF. Ganglion Cyst. StatPearls. Treasure Island (FL): StatPearls Publishing

Copyright © 2021, StatPearls Publishing LLC.; 2025.

Craik JD, Walsh SP. Patient outcomes following wrist ganglion excision surgery. J Hand Surg Eur Vol. 2012;37(7):673-7 10.1177/1753193411434376: http://doi.org/[10.1177/1753193411434376

Kumar P, Giroti C, Dhobal A, Singh AR. Management of ganglion by double loop suture technique. Asian J Med Sci. 2023;14(2):188-91.

Koehl P, Rueth MJ, Sesselmann S, Necula R, Mada L, Schuh A. [Wrist ganglion]. MMW Fortschr Med. 2023;165(2):56-7 10.1007/s15006-022-2131-1: http://doi.org/[10.1007/s15006-022-2131-1

Hamlin K, Haddon A, Khan Y, Miller C, Lawrie D. Dorsal Wrist Ganglion: Pilot for Randomized Control Trial Comparing Aspiration Alone or Combined with Injection of Platelet-Rich Plasma. J Wrist Surg. 2023;12(1):18-22 10.1055/s-0042-1744367: http://doi.org/[10.1055/s-0042-1744367

Chaudhary S, Mandal S, Kumar V. Results of modified thread technique for the treatment of wrist ganglion. J Clin Orthop Trauma. 2021;13:57-62 10.1016/j.jcot.2020.08.018: http://doi.org/[10.1016/j.jcot.2020.08.018

Cluts LM, Fowler JR. Factors Impacting Recurrence Rate After Open Ganglion Cyst Excision. Hand (N Y). 2022;17(2):261-5 10.1177/1558944720921477: http://doi.org/[10.1177/1558944720921477

Zangana AM, Dizaye KF. A New Method in the Management of Wrist Ganglion ( Silk Thread Passed through the Ganglion ) in Comparison with Other Traditional Methods. World Family Medicine Journal/Middle East Journal of Family Medicine. 2016;14(1):15-20 10.5742/mewfm.2015.92791: http://doi.org/[10.5742/mewfm.2015.92791

Ahmad Shah A, Raina AH, Ganie MA, Kumar IA. Comparison of Aspiration Followed by Intra-Lesional Steroid Injection and Surgical Excision in Management of Dorsal Wrist Ganglion. World J Plast Surg. 2019;8(2):181-4 10.29252/wjps.8.2.181: http://doi.org/[10.29252/wjps.8.2.181

Bram JT, Falk DP, Chang B, Ty JM, Lin IC, Fazal FZ, et al. Clinical Presentation and Characteristics of Hand and Wrist Ganglion Cysts in Children. J Hand Surg Am. 2021;46(12):1122 e1- e9 10.1016/j.jhsa.2021.02.026: http://doi.org/[10.1016/j.jhsa.2021.02.026

Zhang A, Falkowski AL, Jacobson JA, Kim SM, Koh SH, Gaetke-Udager K. Sonography of Wrist Ganglion Cysts: Which Location Is Most Common? J Ultrasound Med. 2019;38(8):2155-60 10.1002/jum.14912: http://doi.org/[10.1002/jum.14912

Lyon C, Eldred SV, Desanto K. What is the best treatment for wrist ganglion cysts? J Fam Pract. 2020;69(1):E23-E4.

Horvath A, Zsidai B, Konaporshi S, Svantesson E, Hamrin Senorski E, Samuelsson K, et al. Treatment of Primary Dorsal Wrist Ganglion-A Systematic Review. J Wrist Surg. 2023;12(2):177-90 10.1055/s-0042-1753542: http://doi.org/[10.1055/s-0042-1753542

Kulinski S, Gutkowska O, Mizia S, Martynkiewicz J, Gosk J. Dorsal and volar wrist ganglions: The results of surgical treatment. Adv Clin Exp Med. 2019;28(1):95-102 10.17219/acem/81202: http://doi.org/[10.17219/acem/81202

Shanks C, Schaeffer T, Falk DP, Nunziato C, Hogarth DA, Bauer AS, et al. The Efficacy of Nonsurgical and Surgical Interventions in the Treatment of Pediatric Wrist Ganglion Cysts. J Hand Surg Am. 2022;47(4):341-7 10.1016/j.jhsa.2021.12.005: http://doi.org/[10.1016/j.jhsa.2021.12.005

Saeed B, Ullah JS, Aziz M, Shahid M, Siraj AS, Tariq SR. Comparison of Recurrence Rate of Wrist Ganglion Between Seton and Open Surgical Excision in Military Hospitals of Pakistan. Pak Armed Forces Med J 2023;73(1):50-3.

Thapa P, Lakhey RB. Successful Outcome of Transfixation Technique with Linen in Dorsal Wrist Ganglion: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc. 2021;59(243):1150-4 10.31729/jnma.6574: http://doi.org/[10.31729/jnma.6574

Kour R, Sharma G, Kour G, Gupta K, Sharma R. Determine the results of treatment of dorsal wrist ganglia by using the transfixation technique: an observational study. JK Practitioner. 2021;26(3).

Shakya A, Garje V, Rathore A. The triple technique: A simple and effective outpatient procedure for the dorsal wrist ganglion. J Clin Orthop Trauma. 2021;23:101619 10.1016/j.jcot.2021.101619: http://doi.org/[10.1016/j.jcot.2021.101619

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Copyright (c) 2025 Abdul Basit, Salman Habib Abbasi, Muhammad Farooq, Fazal Hussain Shah