Polymers in Medicine

Polim. Med.
Scopus CiteScore: 3.5 (CiteScore Tracker 3.6)
Index Copernicus (ICV 2023) – 121.14
MEiN – 70
ISSN 0370-0747 (print)
ISSN 2451-2699 (online) 
Periodicity – biannual

Download PDF

Polymers in Medicine

2016, vol. 46, nr 1, January-June, p. 95–100

doi: 10.17219/pim/64803

Publication type: review article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Creative Commons BY-NC-ND 3.0 Open Access

Chemical Substances Used in the Treatment of Ganglions Located in the Hand and Wrist

Sebastian Kuliński1,A,C,D, Olga Gutkowska1,A,B,D, Jerzy Gosk1,A,B,C,E,F

1 Department of Traumatology, Clinical Department of Traumatology and Hand Surgery, Wroclaw Medical University, Wroclaw, Poland

Abstract

The aim of this work was to compare different chemical substances used in the treatment of ganglions located in the hand and wrist region. Their basic properties and mechanisms of action have been described. Moreover, the risks associated with the use of particular substances have been highlighted and potential complications connected with their administration have been discussed. On the basis of the available literature, the results of ganglion aspiration treatment followed by an injection of a chemical substance into the cyst cavity have been assessed. In the authors’ opinion, due to the existing risk of complications associated with this treatment, as well as the relatively high rate of ganglion recurrence, this procedure should only be performed by qualified medical personnel. The authors recommend observation in cases of asymptomatic ganglions of the hand and wrist, and operative treatment in cases in which pain, restriction of limb mobility and weakening of handgrip strength are observed.

Key words

steroids, wrist, hand, ganglion cysts, hyaluronoglucosaminidase

References (25)

  1. Gude W., Morelli V.: Ganglion cysts of the wrist: Pathophysiology, clinical picture, and management. Curr. Rev. Musculoskelet Med. 2008, 1, 205–211. doi: 10.1007/s12178-008-9033-4.
  2. Minotti P., Taras J.S.: Ganglion cysts of the wrist. J. Hand Surg. 2002, 2, 102–107. doi: http://dx.doi.org/10.1053/ jssh.2002.33318.
  3. Shoaib A., Clay N.R.: Ganglions. Curr. Orthop. 2002, 16, 451–461. doi: http://dx.doi.org/10.1054/cuor.2002.0289.
  4. Gant J., Ruff M., Janz B.A.: Wrist ganglions. J. Hand Surg. Am. 2011, 36, 510–512. doi: 10.1016/j.jhsa.2010.11.048.
  5. Meyer K.: Hyaluronidases. [In:] The enzymes, Ed.: Boyer P.D., Vol. V. London: Academic Press, New York 1971, 3rd ed., 307–320.
  6. Otu A.A.: Wrist and hand ganglion treatment with hyaluronidase injection and fine needle aspiration: A tropical African perspective. J R Coll Surg. Edinb. 1992, 37, 405–407.
  7. Paul A.S., Sochart D.H.: Improving the results of ganglion aspiration by the use of hyaluronidase. J. Hand Surg. Br. 1997, 22, 219–221.
  8. Jagers Op Akkerhuis M., Van Der Heijden M., Brink P.R.: Hyaluronidase versus surgical excision of ganglia: A prospective, randomized clinical trial. J. Hand Surg. Br. 2002, 27, 256–258.
  9. Hajer G.F., Scheltinga M.R.M., Bakker X.R., Wijburg E.R.: Hyaluronidase aspiration vs surgical excision of ganglion cysts: A randomized controlled trial. Eur. J. Plast. Surg. 2005, 28, 337–339. doi: 10.1007/s00238-005-0785-4.
  10. Chatterjee S., Basu A., Gupta S., Biswas S.: Comparative study of recurrence and complications using various sclerosants by single dart technique in treatment of ganglion cysts. Indian J. Surg. 2014, 76, 350–353. doi: 10.1007/s12262-012-0711-5.
  11. Derbyshire R.C.: Observations on the treatment of ganglia with a report on hydrocortisone. Am. J. Surg. 1966, 112, 635– 636.
  12. Holm P.C., Pandey S.D.: Treatment of ganglia of the hand and wrist with aspiration and injection of hydrocortisone. Hand 1973, 5, 63–68.
  13. Varley G.W., Needoff M., Davis T.R., Clay N.R.: Conservative management of wrist ganglia. Aspiration versus steroid infiltration. J. Hand Surg. Br. 1997, 22, 636–637.
  14. Nasab S.A.M., Mashhadizadeh E., Sarrafan N.: Comparative study between three methods of aspiration alone, aspiration plus steroid injection and aspiration plus ethanol injection for treatment of dorsal wrist ganglions. Pakistan J. Med. Sci. 2012, 28, 404–407.
  15. Limpaphayom N., Wilairatana V.: Randomized controlled trial between surgery and aspiration combined with methylprednisolone acetate injection plus wrist immobilization in the treatment of dorsal carpal ganglion. J. Med. Assoc. Thai. 2004, 87, 1513–1517.
  16. Colberg R.E., Sánchez C.F., Lugo-Vicente H.: Aspiration and triamcinolone acetonide injection of wrist synovial cysts in children. J. Pediatr. Surg. 2008, 43, 2087–2090. doi: 10.1016/j.jpedsurg.2008.04.004.
  17. Paramhans D., Nayak D., Mathur R.K., Kushwah K.: Double dart technique of instillation of triamcinolone in ganglion over the wrist. J. Cutan. Aesthet. Surg. 2010, 3, 29–31. doi: 10.4103/0974-2077.63286.
  18. Woods J.E.: Extended use of sodium tetradecyl sulfate in treatment of hemangiomas and other related conditions. Plast. Reconstr. Surg. 1987, 79, 542–549.
  19. O’Donovan J.C., Donaldson J.S., Morello F.P., Pensler J.M., Vogelzang R.L., Bauer B.: Symptomatic hemangiomas and venous malformations in infants, children, and young adults: treatment with percutaneous injection of sodium tetradecyl sulfate. AJR Am. J. Roentgenol. 1997, 169, 723–729.
  20. Mackie I.G., Howard C.B., Wilkins P.: The dangers of sclerotherapy in the treatment of ganglia. J. Hand Surg. Br. 1984, 9, 181–184.
  21. Ashindoitiang J.A.: Preliminary report of the effectiveness of tetracycline sclerotherapy in treatment of ganglion. Plast. Surg. Int. 2012, 2012, 624209. doi: 10.1155/2012/624209.
  22. Park S., Iida T., Yoshimura K., Kawasaki Y.: Phenol cauterization for ganglions of the hand, wrist, and foot: A preliminary report. Ann. Plast. Surg. 2002, 48, 582–585.
  23. Dogo D., Hassan A.W., Babayo U.: Treatment of ganglion using hypertonic saline as sclerosant. West Afr. J. Med. 2003, 22, 13–14.
  24. Singhal R., Angmo N., Gupta S., Kumar V., Mehtani A.: Ganglion cysts of the wrist: A prospective study of a simple outpatient management. Acta Orthop. Belg. 2005, 71, 528–534.
  25. Humail S.M., Abidi A.R., Haq S.N.U., Mustafa G.K.K.: Comparative study of two methods for treatment of dorsal wrist ganglion. J. Pak. Orthop. Assoc. 2010, 22, 53–57.