A Comparative Study of Nail Fold Approach and Microscopic Nail Bed Approach in the Surgical Treatment of Subungual Exostosis.

Abstract:

ABSTRACT:Subungual exostosis is a benign tumor that occurs under the nail plate of the distal phalanx and causes nail deformity and pain. There are many reports of recurrence and postoperative nail deformity, and the surgical approach needs to be reassessed. Two typical surgical approaches are from the nail fold and the nail bed. Here, we compare 2 surgical approaches for subungual exostosis that were performed in our department. Twenty-three cases of subungual exostosis were treated between 2010 and 2019; 12 cases were treated by the nail fold approach and 11 by the microscopic nail bed approach. The nail fold approach resulted in not only scarring but also nail deformities, such as onychodystrophy. There were 2 (18.2%) cases of recurrence. In the microscopic nail bed approach, there was no case of recurrence. It was possible to preserve the thinned nail bed by dissecting under a microscope, and the thinned nail bed did not become necrotic in any cases. To solve postoperative nail deformity and a high recurrence rate, sufficient resection and meticulous surgical procedure on the nail bed and nail matrix are essential. The microscopic nail bed approach satisfied both of these criteria and was considered to be a useful method for subungual exostosis.

journal_name

Ann Plast Surg

authors

Kusuhara H,Itani Y,Isogai N,Sueyoshi Y

doi

10.1097/SAP.0000000000002619

subject

Has Abstract

pub_date

2020-12-15 00:00:00

eissn

0148-7043

issn

1536-3708

pii

00000637-900000000-96410

journal_volume

Publish Ahead of Print

pub_type

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