Chaudhary Sumedh, Mandal Sourav, Kumar Vikram
Department of Orthopaedics, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India.
J Clin Orthop Trauma. 2020 Aug 27;13:57-62. doi: 10.1016/j.jcot.2020.08.018. eCollection 2021 Feb.
Ganglion cyst is the commonest swelling around the wrist. It usually presents as a painless swelling. There is no consensus as to the exact cause and the ideal modality of its treatment. Surgical excision has the best cure rates but has its share of complications. The aim of this study was to evaluate whether a modified thread technique can give reasonably good results with a low complication rate in patients with wrist ganglion.
One hundred and sixteen patients with wrist ganglion underwent a modified thread technique in which a sterile silk suture was passed through the ganglion, the contents of the ganglion were expressed out completely by firm pressure and the thread was tied over a sterile gauze piece forming a single loop. The thread was removed once serosanginous discharge was seen at entry point of the thread into the cyst.
One hundred and eight patients were available for final analysis with minimum six months follow up. There was no recurrence in ninety eight patients giving success rate of ninety one percent. Recurrence was only seen in patients where complete evacuation of the contents of ganglion could not be achieved. Nine patients had minor complications in the form of superficial infection in two patients and mild pain around thread entry point in seven patients.
Modified thread technique for the treatment of wrist ganglion is a minimally invasive, low cost, day care procedure which can give reasonably good results with a very low complication rate.
腱鞘囊肿是腕部最常见的肿物。通常表现为无痛性肿胀。对于其确切病因及理想的治疗方式尚无共识。手术切除治愈率最高，但也存在一定比例的并发症。本研究的目的是评估改良缝线技术在腕部腱鞘囊肿患者中是否能取得较好的效果且并发症发生率较低。
116例腕部腱鞘囊肿患者接受了改良缝线技术，即通过腱鞘囊肿穿入一根无菌丝线，通过用力挤压将囊肿内容物完全挤出，然后将丝线在一块无菌纱布上打结形成一个单环。一旦在丝线进入囊肿的入口处见到浆液性渗出物，就将丝线取出。
108例患者可供最终分析，随访时间至少6个月。98例患者无复发，成功率为91%。仅在囊肿内容物未完全排空的患者中出现复发。9例患者出现轻微并发症，其中两名患者出现浅表感染，7名患者在丝线入口处周围出现轻度疼痛。
改良缝线技术治疗腕部腱鞘囊肿是一种微创、低成本的日间手术，能取得较好的效果且并发症发生率极低。
