Benign Subungual Tumors

“…Subungual tumors encompass diverse phenotypes from benign to malignant and have a variety of clinical manifestations. 1,2 The typical clinical manifestations of subungual bone tumors involve painful, hard, and exophytic masses, nail deformities, nail bed damage resulting in discharge or infection, and nail lifting or extraction, often compromising quality of life. 1 Benign subungual bone tumors include osteochondromas, exostosis, and enchondromas.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 The typical clinical manifestations of subungual bone tumors involve painful, hard, and exophytic masses, nail deformities, nail bed damage resulting in discharge or infection, and nail lifting or extraction, often compromising quality of life. 1 Benign subungual bone tumors include osteochondromas, exostosis, and enchondromas. 3 Standard care typically includes tumor excision nail apparatus preservation.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…3 Standard care typically includes tumor excision nail apparatus preservation. 1 Despite the relatively small size and superficial location of these tumors, surgical approaches are sometimes very difficult because the nail bed is located just above the mass. Therefore, proper surgical technique is the most critical factor to prevent nail deformities and reduce recurrence.…”

Section: Introductionmentioning

confidence: 99%

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A modified proximally based nail bed flap approach for benign subungual bone tumors in the distal phalanx

Hong

Kim

Jang

et al. 2019

J Orthop Surg (Hong Kong)

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Background: Complete tumor removal and damaged nail bed repair are critical factors that determine the success of subungual tumor excision. We examined a modified proximally based nail bed flap approach for excision of subungual bone tumors of the distal phalanx and present cases where this approach was used, along with postoperative functional and cosmetic outcomes. Methods: Twenty-four benign subungual bone tumors, identified from 23 patients (9 males and 14 females), were included in this study. All patients underwent tumor excision by the modified proximally based nail bed flap approach. Pain was assessed using a numeric rating scale, and cosmesis was self-assessed using a visual analog scale preoperatively and 1 year postoperatively. We measured sensation of the involved digit tip, relative to opposite-side sensation, using static and moving two-point discrimination and Semmes–Weinstein monofilament tests 1 year postoperatively. Lastly, we assessed postoperative nail deformities and tumor recurrence as potential surgical complications. Results: Mean pain severity and cosmesis were significantly improved 1 year postoperatively. There were no significant differences in the digit tip sensation between the involved and the opposite-side digits 1 year postoperatively. We observed one case of tumor recurrence and four cases of postoperative nail deformities. Conclusions: The modified proximally based nail bed flap approach showed satisfactory functional and cosmetic outcomes. This approach enables a low rate of recurrence after removal of benign subungual bone tumors in the short term and cosmetically superior nail bed repair. Level of evidence: Therapeutic, IV

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