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.

INTRODUCTIONTibial anterior cruciate ligament (ACL) avulsion fractures are a common injury in children and adolescents. In adults they account for 1% to 5% of ACL injuries.1 They are caused by a hyperextension injury of the knee or by a direct force over the distal femur with the knee in flexion. Meyers and McKeever have classified these injuries depending on the amount of displacement of the ACL tibial fragment as follows: type 1-minimal or undisplaced fracture fragment; type 2-elevation of only the anterior half of the fragment; type 3-complete displacement of the ABSTRACT Background: Tibial anterior cruciate ligament (ACL) avulsion fractures are a common injury in children and adolescents. Operative treatment is indicated for type 2, 3 and 4 fractures. Arthroscopic fixation is the preferred method and numerous fixation options are described. The purpose of this study is to evaluate the results of a new technique of arthroscopic fixation. Methods: A retrospective study was done involving twelve patients having displaced ACL tibial avulsion fractures. The arthroscopic suture "bridge" pull out technique was used to fix these fractures. Patient symptoms like knee pain, locking, clicking, sensation of giving way and clinical signs like tenderness, range of motion, Mc Murray's test, stability test and Lysholm knee scores were evaluated pre operatively and post operatively at 3 months and 6 months. Patient satisfaction was noted at latest follow up. Results: One patient had type 2, 7 patients had type 3 and 4 patients had type 4 tibial ACL avulsion fractures. All the fractures united and all patients achieved full knee range of motion by 2 months post-operative. The clinical symptoms and signs improved post operatively. The mean Lysholm knee score at 3 months follow up was 88.8 and at 6 months follow up were 98.8. At latest follow up, all the patients were satisfied with their knee function. Conclusions: The arthroscopic suture "bridge" pull out technique is an effective method for fixation of ACL tibial avulsion fractures with respect to knee stability, range of motion and resumption of pre injury activity level.