Endoscopic Resection of Horseshoe Ganglion of the Great Toe

Twelve percent of the foot ganglion cysts occur on the toes, and they are often symptomatic and recurrent. When conservative treatment failed, surgical excision is recommended, which is classically an open resection of the ganglion cyst. However, communicating lesions between ganglion cysts and the interphalangeal joint or tendon sheath make it difficult to prevent a recurrence. Techniques of arthroscopic or endoscopic toe ganglionectomy have been reported, which is either arthroscopic/endoscopic internal drainage to the adjacent joint or tendon sheath or endoscopic resection of the ganglion cyst. Difficulty in identifying the communicating valvular lesion and high incidence of multiloculated lesions make endoscopic internal drainage not always feasible for toe ganglion. The purpose of this Technical Note is to describe the details of endoscopic resection of horseshoe ganglion of the great toe. This minimal invasive approach may help to reduce the risk of recurrence.