• The Journal of the Korean bone and joint tumor society
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• v.18 no.2
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• pp.83-88
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• 2012

We reviewed the clinical features of 2 patients who underwent surgery for subungal exostosis, focusing on postoperative deformity of the nail. The lesion destroyed the nail bed and was excised with a direct approach. then thin split-thickness sterile matrix graft was done after excision of the tumor because the defect of the nail bed was large. Good postoperative appearance of the nail was obtained by thin split-thickness sterile matrix graft. The use of thin split-thickness sterile matrix graft for the replacement of a nail bed defect can regain a smooth, adherent, and normal-looking nail and avoid donor-site morbidity. Thin split-thickness toe-nail bed graft is a good choice for the prevention of postoperative deformity.

• Journal of Korean Foot and Ankle Society
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• v.2 no.1
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• pp.13-18
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• 1998

Subungal exostosis is a rare benign cartilaginous tumor affecting the distal phalanx. From 1995 to 1996, six subungal exostoses of the hallux were treated in the Chonnam national university hospital. The symptoms were subungal pain, mass on the distal phalanx elevating the nail or causing ulceration of the nail bed. The plain radiological examination showed a bony mass occurring on the dorsomedial or medial aspect of the distal phalanx. The diagnosis of the subungal exostosis of the hallux were suspected from clinical presentation and confirmed with radiographic examination. Histological patterns were fibrocartilaginous cap with the mature trabecular bone. Complete excision of the lesion including overlying nail bed was curative without recurrence in all cases.

• Archives of Plastic Surgery
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• v.50 no.6
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• pp.573-577
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• 2023

Pachyonychia congenita is a rare genetic disorder characterized by hypertrophic nail plates, hyperkeratotic nail beds, and thickened hyponychium of the fingers and toes, impairing manual dexterity and resulting in poor aesthetics. The current body of literature describes various treatment modalities, but no singular approach has been defined as the gold standard. In this case, the authors employed different surgical techniques for treating pachyonychia congenita to evaluate the most effective approach. A 3-year-old boy presented with hypertrophic nail growth involving all digits of both hands and feet. Three surgical procedures were performed on the patient's fingers and toes using germinal matrix excision (GME) alone, GME plus partial sterile matrix excision (pSME), or GME plus complete sterile matrix excision (cSME). The digits treated with GME + cSME exhibited no recurrence of nail growth. Those treated with GME alone exhibited recurrence of hypertrophic nail growth, although their growth slowed. Excision of GME + cSME prevented recurrence of hypertrophic nails, while GME alone or with pSME led to slower-growing hypertrophic nails. Complete excision of the germinal and sterile matrices with skin graft closure may be a definitive treatment for pachyonychia congenita, but further studies are needed to validate these findings.

• The Journal of the Korean bone and joint tumor society
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• v.1 no.2
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• pp.244-248
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• 1995

Glomus tumor is uncommon tumor with an incidence of about 1% in soft tissue tumors and the single most common location is the subungual region of the finger. Many reports have emphasized that glomus tumors were difficult to diagnose and that the result of surgical removal was good, but nail deformity has received little attention. Most of authors removed the entire nail or partially splitted the nail to exposure the nail bed and tumor. Nobody reported whether nail deformity after operation was present or not. But, an abnormal nail is both a cosmetic and a functional problem in that catches on objects. In this study, our attention was postoperative nail deformity as well as the results of surgical removal. Seven patients(eight cases) who were diagnosed as a subungal glomus tumor in the hand were treated by surgical excision without removal of the nail and followed over twenty two months. And then we report on our experience with 8 cases of subungual glomus tumor which were successfully treated by complete excision without nail deformity.

• The Journal of the Korean bone and joint tumor society
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• v.3 no.2
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• pp.105-111
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• 1997

From 1988 to 1997, we experienced 11 cases of glomus tumor in fingers(10 cases) and toe(1 case). All patients were female, and showed typical pain, tenderness, and cold sensitivity of the lesions. The locations were subungal in nine cases and in pulp from distal phalangeal bone in two cases. Three patients had histories of one or two failed previous operations, and two patients had another glomus tumor in their bodies. All except one had satisfactory results subjectively and without complications. One patient was operated by the excision of the tumor including germinal matrix and surrounding tissues of nail bed, and had a nail deformity in follow-up. The glomus tumor is not malignant to recur or metastasize in the case of complete excision. However, the surgeon should be alert not to injure or repair the nail bed meticulously after the excision of the tumor to prevent a late deformity of nail.

• Archives of Plastic Surgery
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• v.51 no.2
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• pp.202-207
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• 2024

Background Ingrown toenail is a common condition that results in chronic pain, recurrent infections, and difficulty in performing daily activities. Our aim is to compare two surgical methods for the treatment of ingrown toenails: wedge resection with curetting versus wedge resection curetting followed by electrocauterization of the nail bed. Methods A prospective, comparative study that included 130 patients with ingrown toenails. All patients had stage II or III disease. We divided the participants into two groups according to the type of surgery and all patients were followed up for 6 months. The outcomes measured were the incidence of postoperative bleeding and infection, recovery time, patient satisfaction, and recurrence rate 6 months after surgery. Results Of the 130 patients included, 59 (45.4%) underwent excision and curetting of the nail matrix (group 1) and 71 (54.6%) underwent excision, curetting, and electrocauterization of the nail matrix (group 2). The postoperative infection rates were 20.3 and 4.2% in the first and second groups, respectively (p = 0.004). Patient satisfaction was 76.3% among the first group, while 91.5% of patients in the second group were satisfied with the results of surgery. Six months postoperatively, recurrence rates were 25.4 and 4.2% in the first and second groups, respectively (p = 0.001). Conclusion Wedge excision and curettage, followed by electrocauterization of the ingrown toenail is a safe treatment modality with a high success rate, that is evident by a lower recurrence rate, and greater patient satisfaction, with no effect on postoperative pain score or recovery time.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.8 no.1
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• pp.16-20
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• 2015

Glomus tumors are rare benign neoplasm commonly found in the subcutaneous layer on nail bed that arises from a neuromyoarterial glomus. Histologically, they are classified into three group; solid glomus tumor, glomangioma, and glomangiomyoma which is the most uncommon. Unlike other type, glomangiomyomas have rarely been described in the nail bed. Although glomus tumors are often diagnosed primarily by their characteristic clinical symptoms, imaging modalities, such as ultrasonography and magnetic resonance imaging can be helpful. We present a rare case of a recurrent subungal glomangiomyoma that diagnosed by ultrasonography and treated with surgical excision.

• Journal of Korean Foot and Ankle Society
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• v.20 no.1
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• pp.50-53
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• 2016

We report on a rare case of an intraosseous epidermoid cyst in the distal phalanx of the great toe with concurrent infection in a 71-year-old woman with diabetes mellitus. The lesion was initially considered simple infectious arthritis and concomitant osteomyelitis in a patient with diabetes. However, after surgery, an intraosseous epidermoid cyst originating from the nail bed and involving the articular surface of the distal phalanx was detected. The epidermoid cyst may have contributed to the infectious arthritis in the interphalangeal joint. The lesion was treated via mass excision, arthrotomy, debridement, and intravenous antibiotics.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.398-400
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• 2011

Purpose: Subungual tumors are a common cause of nail plate deformity, and may be caused by fibrokeratoma, Koene's tumor and glomus tumors. Neurofibromas, either as part of neurofibromatosis or as a solitary tumor are exceptionally rare in the digits. Methods: A 44-year-old man presented with painless onychodystrophy and nail plate elevation of the right thumb due to a small subungual mass that had started growing 3 years ago. Sensory evaluation of the distal phalanx was normal, and no discoloration nor infection signs were seen. The nail plate was extracted under local anesthesia, and the mass was delicately removed without injury to the nail bed. The nail matrix was repaired with primary closure. Results: Histopathology shows a well circumscribed, cellular tumor with myxoid stroma. Tumor cells were S-100 protein positive, and the patient was diagnosed with myxoid neurofibroma. There has been no sign of recurrence to date, 14 months after the operation. Conclusion: Presentation of cutaneous neurofibromas in the digits is an uncommon finding. They may occur as a manifestation of neurofibromatosis or as a solitary tumor. Subungual neurofibromas are exceptionally rare. To our knowledge, there are only ten reports of solitary subungual neurofibroma unrelated to neurofibromatosis to date. We report a rare case of solitary subungual myxoid neurofibroma of the thumb, that was treated through total excision, with preservation of the nail matrix.

• Archives of Plastic Surgery
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• v.42 no.3
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• pp.295-301
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• 2015

Background Glomus tumors were first described by Wood in 1812 as painful subcutaneous tubercles. It is an uncommon benign neoplasm involving the glomus body, an apparatus that involves in thermoregulation of cutaneous microvasculature. Glomus tumor constitutes 1%-5% of all hand tumors. It usually occurs at the subungual region and more commonly in aged women. Its classical clinical triad consists of pain, tenderness and temperature intolerance, especially cold sensitivity. This study reviews 15 cases of glomus tumor which were analyzed according to its anatomic location, surgical approach and histologic findings. Methods Fifteen patients with subungual glomus tumors of the hand operated on between January 2006 and March 2013, were retrospectively reviewed. Patients were evaluated preoperatively with standard physical examination including ice cube test and Love's test. Diagnostic imaging consisted of ultrasonography, computed tomography, and magnetic resonance imaging. All procedures were performed with tourniquet control under local anesthesia. Eleven patients underwent excision using the transungual approach, 3 patients using the volar approach and 1 patient using the lateral subperiosteal approach. Results Total of 15 cases were reviewed. 11 tumors were located in the nail bed, 3 in the volar pulp and 1 in the radial aspect of the finger tip. After complete excision, patients remained asymptomatic in the immediate postoperative period. In the long term follow up, patients exhibited excellent cosmetic results with no recurrence. Conclusions Accurate diagnosis should be made by physical, radiologic and pathologic examinations. Preoperative localization and complete extirpation is essential in preventing recurrence and subsequent nail deformity.