Arthroscopic resection of dorsal wrist ganglion

Abstract

INTRODUCTIONGanglions are the most common causes of focal masses of the hand and wrist. They arise from the synovium of joints or tendon sheaths. Dorsal wrist ganglion is the most common type of ganglion arising from the hand.1 The exact etiology is not known and the most common site of origin is the dorsal scapho-lunate ligament. A one way valve is believed to exist which allows the fluid to enter the swelling from the joint and appear most commonly between the second and fourth extensor tendon compartment.2 The management of dorsal wrist ganglion ranges from benign neglect to open surgical excision. The key to open surgical excision is identification of the ganglion stalk and excision from the base.Open surgical excision is associated with morbidities like numbness around the scar, wrist stiffness, cosmetically unacceptable scar and a recurrence rate ranging from 10% to 40%. 2,3 Wrist arthroscopy has been an innovation in recent times with increasing application for managing wrist pathologies. Arthroscopic resection of dorsal wrist ganglion has advantages of a minimally invasive surgery, early return to function, a more cosmetically acceptable ABSTRACT Background: The management of dorsal wrist ganglion ranges from benign neglect to surgical excision. The purpose of this study was to study the results of arthroscopic resection of dorsal wrist ganglion. Methods: Twenty one patients who had undergone arthroscopic dorsal wrist ganglion excision and a minimum of 3 months follow up were included. The preoperative complaint of cosmesis, pain, and duration of swelling, wrist range of motion and size of the ganglion were noted. The duration the patient took to return to a painless wrist with full range of motion was noted. Patient satisfaction with respect to cosmesis and function was noted. Results: The mean age was 23.3 years (range: 13 to 35 years). Pre-operative wrist pain was present in 17 patients and cosmesis was a complaint in 18 patients. 5 patients had a pre-operative restricted range of motion. The mean duration and size of the ganglion was 2.6 months (range: 2 to 4 months) and1.8cm (range: 1 to 3 cm) respectively. The mean duration of follow up was 14.6 months (range: 3 to 24 months). Arthroscopically, dorsal synovitis was present in 10 patients, triangular-fibro-cartilage-complex (TFCC) tear in 2 patients and chondral damage in 1 patient. The ganglion stalk was visualized in 14 patients. Complete painless wrist range of motion was obtained by 20 patients by 3 weeks post-operative. One patient had a recurrence. All the remaining patients were satisfied cosmetically and functionally with the results. Conclusions: Arthroscopic resection is an effective treatment modality for symptomatic dorsal wrist ganglion with good functional and cosmetic results.

MIC and MBC of Honey and Gold Nanoparticles against methicillin-resistant (MRSA) and vancomycin-resistant (VRSA) coagulase-positive S. aureus isolated from contagious bovine clinical mastitis

“…Many previous research articles studied the effectiveness of honey against MRSA [58], [59], [11], [60], [61]. For example, a previous study revealed that, the MIC of honey was between 15 and 20% v/v for the MRSA isolates [10]. Furthermore, five types of honey against MRSA were found to be active against MRSA but with varying degrees with general MIC and MBC range values observed between 8.33 and 33.3% (w/v) [58].…”

“…Honey consists mainly of sugars, water, minerals, and vitamins, especially B complex and vitamin C. Honey has been orally administrated for years due to their nutritional and therapeutic values; honey possesses anti-oxidant, anti-inflammatory, and anti-bacterial properties. Honey can overcome the multi-drug resistant bacteria [10]. Moreover, honey was able to overcome MRSA biofilms [11].…”