Double Dart Technique of Instillation of Triamcinolone in Ganglion Over the Wrist

BACKGROUND: Ganglia are the most common benign cystic swellings found over both the dorsal and volar aspects of the wrist. In spite of technical advancement, both operative and non-operative interventions achieve more or less similar results. Complete evacuation of gelatinous fluid followed with intra cystic instillation of triamcinolone has given encouraging results. AIMS: To assess the efficacy and safety of drainage of cyst and instillation of triamcinolone in wrist ganglion. MATERIALS AND METHODS: A prospective study was conducted on patients with simple ganglion cysts on the wrist. Total of 219 patients underwent this study. Out of this, 105 patients underwent the aspiration of the cyst fluid followed by intracystic instillation of triamcinolone, and 114 patients underwent surgical excision of wrist ganglia. Two years follow up was done for recurrence. RESULTS: Most ganglia of wrist occurred in the extensor aspect. Complications noted among the surgically excised group were post operative pain and restricted mobility of wrist with a recurrence rate of 21.5%. Instillation of Triamcinolone into the ganglion yielded early resolution with a low recurrence of 8.4%. CONCLUSIONS: Intracystic instillation of triamcinolone after complete evacuation of cyst fluid is a simple and effective technique for treatment of ganglion.