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Nail sparing and sub-nail bed approach for the excision of subungual glomus tumors

Authors
Nam, Jae JunKim, Yong BeenKim, Jae JoongChoi, In CheulPark, Jong Woong
Issue Date
Jun-2022
Publisher
대한수부외과학회
Keywords
Subungual glomus tumor; Nail bed injury; Nail deformity; Sub-nail bed approach
Citation
Archives of Hand and Microsurgery, v.27, no.2, pp 154 - 160
Pages
7
Indexed
KCI
Journal Title
Archives of Hand and Microsurgery
Volume
27
Number
2
Start Page
154
End Page
160
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/61075
DOI
10.12790/ahm.22.0003
ISSN
2586-3290
2586-3533
Abstract
Purpose The excision of subungual glomus tumors on the distal phalanx may cause nail deformities. Herein, we report our nail-sparing and sub-nail bed approach for the excision of subungual glomus tumors, which enables subungual glomus tumor excision without removal of the nail plate and further allows access to the tumor mass by dissecting beneath the nail bed and germinal matrix to minimize postoperative pain and nail bed injury. Therefore, the present article describes this operative approach and reports surgical outcomes with respect to patient satisfaction, pain, and the final postoperative nail shape. Methods Thirty-two cases of clinically diagnosed subungual glomus tumors treated with this approach were retrospectively evaluated. Mean pain scores were measured at 1 week postoperatively and at the last follow-up. Patients were asked for their subjective opinion regarding the final nail shape, and their responses were assessed as “satisfied” or “unsatisfied.” The objective results for the final nail shape were graded as “excellent,” “good,” or “poor” by two orthopedic hand surgeons. Results The mean postoperative pain score (visual analog scale) at 1 week was 1.8. No patients reported pain at the last follow-up. Subjectively, 96.6% of patients were satisfied with the operation. Objectively, the postoperative nail shape was excellent in 9.3% of cases, good in 87.5%, and poor in 3.1%. Conclusion This approach provides minimal postoperative pain, high patient satisfaction, and favorable cosmetic outcomes with respect to the nail shape by avoiding removal of the nail plate and incision of the nail bed and germinal matrix.
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Choi, In Cheul
Anam Hospital (Department of Orthopedic Surgery, Anam Hospital)
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