Subungual exostosis

İnanmaz

et al. 2014

IJOO

Background:In subungual exostosis surgery, repair of the damaged nail bed and surgical excision of the mass without damaging the nail bed is important. The ideal method of surgery is still unclear. This study is done to qualify the effects of different surgical methods on outcome measures in different types of subungual exostosis.Materials and Methods:Fifteen patients, operated with a diagnosis of subungual exostosis between January 2008 and June 2012, were evaluated. Protruded masses were excised with a dorsal surgical approach after the removal of the nail bed and nonprotruded masses were excised through a“fish-mouth” type of incision.Results:The mean age of the patients in protruded subungual exostosis group was 17.3 years (range 13-22 years) and this group consisting of seven female and two male patients. The patients were followed up for a mean of 14.1 ± 4.8 months. The mean age of the patients in the nonprotruded subungual exostosis group was 14.6 years (range 13-16 years) and consisting of six female patients. The patients were followed up for a mean of 11.6 ± 2.9 months. The results were positively affected by changing the surgical approach depending on whether or not the exostosis is protruded from the nail bed. All patients had healthy toe nails in the postoperative period without any signs of recurrence.Conclusions:In patients with a protruded subungual exostosis, the mass should be removed by a dorsal approach with the removal of the nail and injury to the nail bed should be repaired. In patients with a nonprotruded subungual exostosis, the mass should be excised through a “fish-mouth” type incision at the toe tip without an iatrogenic damage.

Section: Discussionmentioning

confidence: 99%

Protruded and nonprotruded subungual exostosis: Differences in surgical approach

İnanmaz

et al. 2014

IJOO

International Journal of Clinical Practice

“…The pathological basis is an inflammatory growth of fibrous and cartilaginous tissue that undergoes endochondral ossification at the base to produce a bony stalk under the fibro‐cartilaginous cap (1,4,5). Plain radiographic finding is an outgrowth with trabeculated pattern of cancellous bone with or without a defined cortex (2,6). Other differential diagnoses include ordinary verrucae, mycoses, pyogenic disease, enchondroma, glomus tumour, melanoma and squamous cell carcinoma (2,5,6).…”

Section: Discussionmentioning

confidence: 99%

“…Plain radiographic finding is an outgrowth with trabeculated pattern of cancellous bone with or without a defined cortex (2,6). Other differential diagnoses include ordinary verrucae, mycoses, pyogenic disease, enchondroma, glomus tumour, melanoma and squamous cell carcinoma (2,5,6). Treatment is by surgical excision of the lesion and curettage of the base (5–7).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Subungual exostosis following toe nail removal - case report

Sankar

Hopgood

et al. 2004

Removal of toe nail is a minor procedure that can be under ring block with no significant complications. We report the case of a young lady who developed a rapidly growing subungual exostosis on her right great toe following nail removal. Inadvertent iatrogenic injury to the nail bed and underlying phalangeal periosteum during nail removal might have triggered off rapid bone growth resulting in the large exostosis. To our knowledge, this aetiology for subungual exostosis formation has not been reported before.

British Journal of Dermatology

“…To avoid leaving residual tumour, good access to the bone surface following removal of the bulk of the tumour is required to allow the effective use of a bone rongeur or similar tool. A bone curette, osteotome or air‐driven burr can be used as alternatives 15 …”

Section: Discussionmentioning

confidence: 99%

Treatment of subungual exostoses by elective day case surgery

Berker

Langtry

1999

Twenty-one patients (11 female, 10 male: mean age 21.3 years) with subungual exostoses were treated with elective surgery under local anaesthetic in a dermatology day case theatre over a period of 8 years. Fifteen (71%) tumours affected the great toe, four (19%) affected other toes and two (10%) affected fingers. All received local excision with great care to remove all tumour residue from the terminal phalanx. Wounds were allowed to heal by secondary intention. Attention was paid to preoperative antiseptic procedure and postoperative analgesia. During follow-up of between 6 and 36 months (mean 17 months), there were two relapses (10%) in the first 12 months, seen in two of the younger subjects aged 9 and 13 years. One required further surgery. One further case suffered long-term dystrophy due to perioperative damage to nail matrix. Conservative and thorough treatment of this pathology can be achieved using the appropriate tools in a dermatology day case theatre.