Treatment of ganglion using hypertonic saline as sclerosant

Twenty-nine patients with ganglion of the wrist were treated in this hospital using hypertonic saline as sclerosant. All patients were treated as outpatients. Under aseptic conditions, the ganglia were aspirated using #18 hyperdermic needle. A mixture of 2 cc of hypertonic saline and 1 cc 1% xylocaine were injected into the empty cavity and crepe bandage applied for 24-48 hours. After a follow-up period of 24-36 months, there was only one recurrence which was believed to be accidental injection of the saline outside the empty cavity. This was treated by the same procedure. The most common complication was swelling of the wrist and dorsum of the hand which were seen in 50% of cases. This subsided spontaneously within 72 hrs of treatment. Severe pain necessitating ingestion of analgesics (Paracetamol) was reported in 6 patients (20%), which subsided within 48 hours. It is hoped that this new treatment which is cheap and less invasive may be a break through in the treatment of ganglia which hitherto was characterised by high recurrence rate of up to 23%.