Abstract:
BACKGROUND:Subungual exostosis is a relatively common benign bone tumor that occurs in the distal phalanges of the toes and can be a source of pain and nail deformity. There is controversy about the treatment of these lesions and there are few studies that have synthesized what is known and provided meaningful information on treatment. QUESTIONS/PURPOSES:We performed a systematic review to address the following questions: (1) What is the best surgical approach for excising these lesions? (2) What is the age range, sex distribution, and presenting symptoms of subungual exostoses and which toe is most frequently affected? (3) What complications arise from treatment? METHODS:Two authors independently searched multiple databases (Medline, 1950-May 2013; Cochrane EBM database, and EMBASE, 1980-May 2013 provided by OVID; ACP Journal Club, 2003-May 2013; CINAHL by EBSCO, 1937-May 2013; and PubMed by NLM, 1940-May 2013), and key words were chosen to achieve a broad search strategy. We included studies on the management of toe exostoses with > 10 cases and we excluded studies that reported on upper extremity exostoses or osteochondromas. Demographic and treatment data were collected from each article by two independent authors and collated. A total of 124 abstracts were screened, and 116 articles were reviewed in full, of which 13 met the inclusion criteria. RESULTS:Complete marginal excision through a fish mouth incision protecting the nail led to a recurrence rate of 4% and satisfactory clinical results, defined as no requirement for postoperative intervention and a satisfactory clinical appearance in 73%. Most studies provided incomplete descriptions of specific surgical techniques used. Fifty-five percent of the patients were younger than 18 years of age. A history of toe trauma before diagnosis was present in approximately 30% of the cases. Delayed diagnosis occurred in approximately 10% of the cases and onychodystrophy occurred in more than 10%. CONCLUSIONS:There is weak evidence to guide management of subungual exostosis. Adequate wound management postexcision aiming to minimize disruption to the nail bed and matrix may prevent onychodystrophy, which is a common complication of treatment.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
DaCambra MP,Gupta SK,Ferri-de-Barros Fdoi
10.1007/s11999-013-3345-4subject
Has Abstractpub_date
2014-04-01 00:00:00pages
1251-9issue
4eissn
0009-921Xissn
1528-1132journal_volume
472pub_type
杂志文章,评审abstract::The purpose of this study was to compare the success rate of bony fusion and the clinical results of rigid instrumentation, nonrigid instrumentation, and no instrumentation for a single level lesion for degenerative lumbar spondylolisthesis. Thirty-three patients with degenerative spondylolisthesis of L4 who had under...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1999-11-01 00:00:00
abstract::The purpose of this study was to explore the relationship between the integrity of collagen and biomechanical properties of bone. In this study, age (range, 5-26 years old) and gender related changes in cortical bone samples from 33 baboon femurs (15 males and 18 females) were examined. The percentage of denatured col...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200002000-00027
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Osteoarthritis is common and debilitating, in part because it often affects more than one large weightbearing joint. The likelihood of undergoing more than one total joint arthroplasty has not been studied in a heterogeneous, multicenter population in the United States. QUESTIONS/PURPOSES:We used prospectiv...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000000925
更新日期:2020-01-01 00:00:00
abstract::We questioned whether our current preoperative demand matching accurately predicted patient activity after TKA. From a prospective database we reviewed 511 patients who had unilateral, primary TKA from 1994 to 1999 and who were preoperatively assessed for five patient characteristics: age, weight, expected postoperati...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000229361.12244.2d
更新日期:2006-11-01 00:00:00
abstract::Bone allografts are commonly used in spinal surgery. Structural allografts placed anteriorly in the spine may be used as interbody grafts or as strut grafts spanning multiple segments. Posterior allografts are used to supplement autologous bone for spinal fusions in patients who lack sufficient host bone and to avoid ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-199603000-00010
更新日期:1996-03-01 00:00:00
abstract:BACKGROUND:The main static stabilizers of the medial knee are the superficial medial collateral and posterior oblique ligaments. A number of reconstructive techniques have been advocated including one we describe here. However, whether these reconstructions restore function and stability is unclear. DESCRIPTION OF TEC...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2061-1
更新日期:2012-03-01 00:00:00
abstract::Tibial articular cartilage and the knee meniscus from cast-immobilized rabbits whose quadriceps were electrically stimulated for 17 days were compared with those from cast-immobilized rabbits without muscle stimulation. Cartilage from non-stimulated rabbits showed evidence of deep fibrillation and loss of Safranin O m...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-10-01 00:00:00
abstract::Biodegradable local antibiotic delivery systems have gained interest for prophylaxis and treatment of musculoskeletal infections. We studied the biodegradable materials Osteo- Set, DBX and Collagraft for local delivery of vancomycin and gentamicin in vitro. We determined the antimicrobial activity of vancomycin and ge...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000229319.45416.81
更新日期:2006-10-01 00:00:00
abstract::Immunohistochemistry and radioimmunoassay were used to study the rejection mechanism of allografted bone tissue in rats through changes in major histocompatibility complex (MHC) antigen expression by osteocytes in the allograft and in alloantibody levels in the serum of the host rats. Some osteocytes in normal rat bon...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:Increasing the number of women in surgical subspecialties has been challenging, especially in orthopaedics, in which the percentage of women has remained relatively the same for the past several decades. Certain subspecialties, such as pediatric orthopaedics, have a greater proportion of women than other ort...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000000823
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:The Bernese periacetabular osteotomy (PAO) has entered its fourth decade and is frequently used for corrective osteotomy in patients with acetabular dysplasia. Although our capacity to preserve the joint after corrective osteotomy is excellent, gaining a better understanding on how well patients function aft...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-014-3980-4
更新日期:2015-02-01 00:00:00
abstract::A series of patients with single major scoliosis curvatures attributable to spina bifida treated by anterior only spinal fusion was studied for 2 years to determine whether the infection rate could be decreased, adequate correction and pelvic balance could be provided, and posterior surgery could be avoided in these p...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199907000-00016
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Septic arthritis is frequently associated with adjacent infections including osteomyelitis and subperiosteal and intramuscular abscesses. While often clinically indiscernible from isolated septic arthritis, the diagnosis of adjacent infections is important in determining the need for additional surgical inte...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999.0000000000000019
更新日期:2018-01-01 00:00:00
abstract::Reconstructive procedures were investigated in meniscal lesions in 14 dogs. Large wedge-shaped lesions were repaired with a graft containing carbon fibers and an organic polymer, prepared from physical mixtures of poly(L-lactide) and a segmented polyurethane. Four and eight weeks postoperation, arthroscopy was perform...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::Specialty boards serve the function of defining qualifications and issuing credentials to assure the public of the specialist's preparation and skill. Over the past 72 years, 23 such boards have been approved and now issue 31 different types of general specialty certificates and 57 types of subspecialty credentials. F...
journal_title:Clinical orthopaedics and related research
pub_type: 历史文章,杂志文章
doi:
更新日期:1990-08-01 00:00:00
abstract:BACKGROUND:Controversy continues regarding the appropriate assessment of fracture risk in long bone lesions affected by disseminated malignancy. QUESTIONS/PURPOSES:The purpose of this ongoing Musculoskeletal Tumor Society-sponsored, multi-institutional prospective cross-sectional clinical study is to compare CT-based ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,多中心研究
doi:10.1007/s11999-015-4453-0
更新日期:2016-03-01 00:00:00
abstract::Varus deformity is a common finding in candidates for total knee arthroplasty (TKA), but very little has been written concerning the problems encountered in correcting these deformities at the time of arthroplasty. Compared to patients without deformities, this group of patients require more attention to the technical...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-12-01 00:00:00
abstract::A new spinal implant has been designed and biomechanical testing completed, intended for application to "short-segment" spinal defects such as disc degeneration, fracture, spondylolisthesis, or tumor. Major improvements over currently available devices include: only 2-3 vertebrae are spanned, not 5-7 as with Harringto...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-02-01 00:00:00
abstract::Ninety-one cases of histologically confirmed osteoid osteoma were collected during an 11-year period; of them, seven (7.6%) had onset of symptoms while younger than five years of age. Special diagnostic difficulties were found in this specific age group: most cases were misdiagnosed or diagnosed incorrectly. The time ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-11-01 00:00:00
abstract::Twenty patients underwent operative arthroscopic procedures of the hip joint. All procedures were performed with the patient in the supine position on a standard fracture table using fluoroscopy through three arthroscopic portals (anterolateral, anterior paratrochanteric, and posterior paratrochanteric). The initial i...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199808000-00018
更新日期:1998-08-01 00:00:00
abstract::The osteoconductive and osteoinductive potential of two human allogeneic demineralized bone matrix putties were compared in a critical-sized athymic rat femoral defect model. Defects were treated with (1) a demineralized bone matrix in a hyaluronic acid carrier, (2) a demineralized bone matrix in a glycerol carrier, (...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000073347.50837.16
更新日期:2003-08-01 00:00:00
abstract::We investigated the effect of shockwaves on cells explanted from normal human periosteum to study the potential mechanisms of their responses and to determine suitable treatment settings. The cells were subjected to one shockwave treatment with systematic combinations of energy intensities (range, 0.05-0.5 mJ/mm) and ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200509000-00042
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Locking titanium plates revolutionized the treatment of osteoporotic and metaphyseal fractures of long bones. However as with any innovation, with time new complications are identified. One of the problems with titanium locking plates is removal of screws, often attributable to cold welding of screw heads in...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1508-0
更新日期:2011-02-01 00:00:00
abstract::Subjective evaluations often are used after knee arthroplasty to quantify function; however, these scores may be influenced by pain and/or function of the nonoperated limb. Multiple influences increase variability of these scores, which in turn may result in a greater change in score required to be considered clinical...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-0811-0
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:Reverse shoulder arthroplasty has been proven to improve function in shoulders with cuff-tear arthropathy, but existing studies are primarily single-center studies with a small number of patients, which limits their ability to identify patients who have an increased risk of revision or a worse functional out...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000001114
更新日期:2020-05-01 00:00:00
abstract::Retrospective review of 30 patients with nonunion of the humeral shaft treated from 1984-1999 revealed nine patients with an initial fracture pattern which to our knowledge was not described previously. Humeral fractures originated at the junction of the proximal and middle thirds of the diaphysis as an hemitransverse...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:2004-07-01 00:00:00
abstract::We evaluated the healing rate, complications, and functional outcomes in 32 adult patients with very short metaphyseal fragments in fractures of the distal tibia treated with a polyaxial locking system. The average distance from the distal extent of the fracture to the tibial plafond was 11 mm. All fractures healed an...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-008-0459-1
更新日期:2009-03-01 00:00:00
abstract::There are no data in the literature concerning the outcome of Colles' fracture beyond six years. One hundred consecutive patients with displaced Colles' fractures were reviewed ten years after the injury. Function, radiographic anatomy, osteoarthrosis, and reflex sympathetic dystrophy (algodystrophy) were all objectiv...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract::An aggregate of biodegradable beta-tricalcium phosphate and bone morphogenetic protein (BMP/TCP) induces the differentiation of cartilage within eight days, cartilage and woven bone within 12 days, and lamellar bone, including bone marrow, within 21 days. The yield of new bone from a 1-mg dose was more than 12 times g...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-07-01 00:00:00
abstract::The formation of a new bone from the lateral wall of the pelvis following blunt injury occurred in a 55-year-old woman. The bone articulated with the top of the trochanter by means of a synovial-lined joint. The case is an example of the remarkable ability of external forces to remodel newly formed bone into a functio...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1979-05-01 00:00:00