scholarly journals Subungual glomus tumour excision: The nail plate flap technique

2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Sandeep Mehrotra ◽  
Vikas Singh ◽  
Uday Singh Dadwal
Keyword(s):  
Nail Plate ◽  
Glomus Tumour ◽  
Nail Bed ◽  
Beneficial Effects ◽  
Flap Technique ◽  
Accurate Localization ◽  
Nail Deformity ◽  
Improved Outcomes ◽  
One Year

<p>Subungual glomus tumours, though rare, cause distressing symptoms and merit surgical treatment with minimal morbidity. Approaches to the nail bed over the years have varied from earlier nail excisions to trans/sub/periungal techniques. Nail plate preservation has beneficial effects on pain, and cosmesis and surgical modifications to ensure the same are desirable. We employed a simple nail preservation technique on six patients over the last seven years. After an accurate localization of the lesion based on pin test and MRI, a proximally-based nail plate flap was marked and elevated beyond the glomus. The tumour was removed through a linear nail-bed incision, following which the nail plate flap was reposited without suturing. All cases had gratifying relief of symptoms. Within a few weeks of the excision, no nail distortion was noticeable. No recurrences were noted on follow-up for one year. The nail flap transungal approach relies on accurate preoperative tumour localization. It ensures a protective post-operative cover with reduced pain. A minimalistic approach with no skin incisions ensures less morbidity and improved cosmesis with no nail deformity. The nail plate flap technique can be employed in selected cases for improved outcomes.</p>

scholarly journals Subungual Glomus Tumor: A Review of 15 Cases Treated with Partial Nail Plate Excision Technique

2021 ◽  
Author(s):  
Mahmoud Farzan ◽  
Mahdi Neshan ◽  
Amir Reza Farhoud ◽  
Abbas Abdoli
Keyword(s):  
Glomus Tumor ◽  
Nail Plate ◽  
Tumor Location ◽  
Tumor Treatment ◽  
Nail Bed ◽  
Nail Deformity ◽  
Surgical Methods ◽  
The Matrix ◽  
The Mean

Background: Although there are various surgical methods for subungual glomus tumor treatment, there is no consensus on the optimal surgical approach. Methods: We analyzed the outcomes of 15 patients treated with partial nail plate excision technique. The medial or lateral section of the nail plate was excised longitudinally based on the tumor location. After incision of the nail bed and tumor removal, the matrix was repaired carefully. Results: In this study, 15 people, including 11 men and four women, were studied. The mean onset of symptoms until diagnosis was 88 months. In the postoperative evaluation, the mean follow-up was 20 months. Two patients had recurrent tumors, and one had postoperative nail deformity. Conclusion: Meticulous nail bed repair and complete tumor excision are key treatment points needed to prevent nail deformity and recurrence.  

Modified retrograde tendon flap technique for reconstructing the extensor tendon defect in zone Ⅱ of a finger

2020 ◽  
Author(s):  
Li Wang ◽  
Jingyu Zhang ◽  
Linjie Feng ◽  
Guoyong Yuan
Keyword(s):  
Range Of Motion ◽  
Extensor Tendon ◽  
Passive Motion ◽  
Finger Joints ◽  
Flap Technique ◽  
Tendon Defect ◽  
Nail Deformity ◽  
Active Flexion ◽  
Extensor Lag

Abstract Purpose: To evaluate the effect of the modified retrograde tendon flap technique for reconstructing the extensor tendon defect in zone Ⅱ of a finger.Methods: 12 patients with the extensor tendon defect in zone Ⅱ were investigated retrospectively. They were all treated surgically by the modified retrograde tendon flap technique, featuring the creation of a new terminal slip to bridge the extensor tendon defect using extensor tendon inner lateral bands. At the final follow-up, the range of motion at each joint of the injured finger was recorded.Results: Average follow-up was 18 months (ranging from 11 to 26 mos). Eight patients achieved full active DIPJ extension, whereas one patient had an extensor lag of 10° and three had a lag of 5°. All patients achieved normal active flexion ranges and full passive motion ranges of DIPJ compared with their uninjured side. All the involved finger joints were clinically stable, with no tenderness, pain, nail deformity, or limitation using their hands for daily life.Conclusions: The modified retrograde tendon flap technique, which is easy to operate and popularize, may be the procedure of choice in patients with a gap deficiency in Zone Ⅱ of the extensor tendon of a finger.

Subungual glomus tumours of the hand: diagnosis and outcome of the transungual approach

2009 ◽  
Vol 34 (5) ◽  
pp. 685-688 ◽  
Author(s):  
I. J. LEE ◽  
D. H. PARK ◽  
M. C. PARK ◽  
N. S. PAE
Keyword(s):  
Local Recurrence ◽  
Severe Pain ◽  
Nail Plate ◽  
Glomus Tumour ◽  
Nail Bed ◽  
Surgical Microscope

We report 17 patients with a subungual glomus tumour. All complained of pain and tenderness when touched, and nine patients experienced severe pain in the cold. A transungual approach with nail plate avulsion on one side was used in all cases. A surgical microscope was used to localise and dissect the tumour and to repair the nail bed and matrix. This method has produced good results, without local recurrence or postoperative nail plate deformity.

Operative Treatment of the Ingrown Toenail With a Less-Invasive Technique: Flashback to the Original Winograd Technique

2017 ◽  
Vol 11 (2) ◽  
pp. 138-141 ◽  
Author(s):  
Yalkin Camurcu ◽  
Hakan Sofu ◽  
Ahmet Issin ◽  
Nizamettin Kockara ◽  
Hakan Saygili
Keyword(s):  
Nail Plate ◽  
Case Series ◽  
Operation Time ◽  
Invasive Technique ◽  
Nail Bed ◽  
Less Invasive ◽  
Ingrown Toenail ◽  
Case Series Study ◽  
Stage 1

Objective: The aim of this study was to evaluate the results of the partial nail plate excision and curettage of nail bed and matrix (the original Winograd technique) in patients with ingrown toenail. Materials and methods:Patients with ingrown toenail who were treated surgically from May 2014 to June 2015, with a minimum follow-up of 1 year were included in this study. Those who had previous ingrown toenail surgery were excluded. Partial nail plate excision with curettage of nail bed and nail matrix was performed for all patients. Rifampicin soaked sterile gauze was placed onto the wounds after the procedure. Results:The study population included 100 males and 89 females with a mean age of 30 years. Eight patients (4.2%) had stage 1, 71 patients (37.6%) had stage 2, and 110 patients (58.2%) had stage 3 ingrown toenails. The mean operation time was 4.8 minutes. No complication occurred during the procedure. It was found that 15 patients (7.9%) had recurrence during the follow-up. Conclusion:The original Winograd technique is an efficient and less-invasive technique for the treatment of ingrown toenail, with lower rates of recurrence and complications. Levels of Evidence: Therapeutic Case Series Study, Level IV

A MODIFIED PERIUNGUAL APPROACH FOR TREATMENT OF SUBUNGUAL GLOMUS TUMOUR

Hand Surgery ◽  
2007 ◽  
Vol 12 (03) ◽  
pp. 217-221 ◽  
Author(s):  
S. T. Fong ◽  
Y. L. Lam ◽  
Y. C. So
Keyword(s):  
Surgical Excision ◽  
Glomus Tumour ◽  
Complete Excision ◽  
Nail Bed ◽  
Peripheral Lesion ◽  
Nail Deformity ◽  
Complete Surgical Excision ◽  
Central Lesions

Subungal glomus tumours are uncommon; the only treatment is complete surgical excision. Transungual approach is often preferred; however, secondary nail deformity may occur. Lateral periungual approach is used to avoid this complication, but this approach provides limited exposure and is used for peripheral lesion only. We describe a modified periungual approach which can be applied to central lesions. This approach can provide adequate exposure for complete excision of the subungual tumour while avoiding incision of the nail bed.

scholarly journals A novel surgical method for total nail ablation: Use of triple flap technique

2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Berna Aksoy ◽  
Hasan Mete Aksoy
Keyword(s):  
Nail Plate ◽  
Dorsal Surface ◽  
Treatment Method ◽  
Advancement Flap ◽  
Nail Bed ◽  
Cosmetic Appearance ◽  
Flap Technique ◽  
Nail Matrix ◽  
Skin Coverage ◽  
Transverse Strip

<p>Total nail ablation for the treatment of onychodystrophies can be performed by using chemicals, surgical resection or laser ablation of nail matrix.<strong> </strong>A female patient with bilateral severe onychodystrophy as a result of inadvertent previous nail surgeries was treated surgically. Proximal complete nail matrix resection and distal 10 mm wide transverse strip partial nail bed resection were performed. A 5 mm wide transverse strip of nail bed was left intact proximally. Proximal nail matrix defect was closed by using the skin of proximal nail fold. The distal nail bed defect was reconstructed by using triple flap technique which was composed of a main central advancement flap containing ventral toe skin and two side flaps containing nail fold skin. The patient healed without any problem and her nail problem was treated successfully. The cosmetic appearance of her first toes was acceptable. Surgical nail ablation followed by volar skin coverage of dorsal surface of the distal phalanx bone by using triple flap technique is an effective surgical treatment method for the correction of advanced nail plate deformities requiring total nail ablation. </p>

Subungual Glomus Tumours: A Different Approach to Diagnosis and Treatment

1997 ◽  
Vol 22 (2) ◽  
pp. 228-229 ◽  
Author(s):  
A. EKIN ◽  
M. ÖZKAN ◽  
T. KABAKLIOGLU
Keyword(s):  
Surgical Technique ◽  
Operative Technique ◽  
New Method ◽  
Diagnosis And Treatment ◽  
Glomus Tumour ◽  
Nail Bed ◽  
Minimal Defect ◽  
Nail Deformity

Nine cases of subungual glomus tumour in which a transillumination test was used for diagnosis and a different operative technique was used to prevent postoperative nail deformity are described. The transillumination test is a new method for identifying a glomus tumour. With our surgical technique it is simple to approach a glomus tumour under the proximal nail bed and it produces a minimal defect.

Reconstruction of the Great Toe Ski-Slope, Sunken-Nail Deformity with a Buried Adipofascial Flap

2004 ◽  
Vol 94 (6) ◽  
pp. 578-582
Author(s):  
Thomas S. Roukis ◽  
Adam S. Landsman
Keyword(s):  
Nail Plate ◽  
Surgical Excision ◽  
Distal Phalanx ◽  
Great Toe ◽  
Nail Bed ◽  
Adipofascial Flap ◽  
Nail Deformity ◽  
Complete Surgical Excision ◽  
Surgical Options ◽  
Normal Architecture

Development of a ski-slope deformity following loss of the great toe nail plate is a problematic condition with few conservative or surgical options available. The condition becomes more difficult to treat when the distal, medial, and lateral labial nail folds are hypertrophied, creating the appearance of a sunken nail. We present a case of ski-slope, sunken-nail deformity following multiple attempts at chemical nail matrixectomy. The patient’s persistent pain and deformity were managed through 1) nail plate avulsion and complete surgical excision of the germinal nail matrix, 2) remodeling of the distal phalanx, and 3) elevation of an adipofascial flap from the plantar tuft of the great toe, which was brought from plantar to dorsal and interposed between the dorsal aspect of the distal phalanx and the overlying nail bed in buried fashion. The combination of these procedures elevated the nail bed, which restored normal architecture to the great toe and relieved the pain associated with the chronic deformity. This case demonstrates a potential complication of a commonly performed procedure and a salvage technique useful for dealing with the resultant ski-slope, sunken-nail deformity (J Am Podiatr Med Assoc 94(6): 578–582, 2004)

Graft Reposition on Flap: Mid-Term Result in Allen Type IV Amputation

2019 ◽  
Vol 24 (02) ◽  
pp. 219-223 ◽  
Author(s):  
Vijay A. Malshikare
Keyword(s):  
Learning Curve ◽  
Local Flaps ◽  
Term Result ◽  
Nail Bed ◽  
Type Iv ◽  
Nail Deformity ◽  
Surgical Units ◽  
Surgical Options ◽  
Finger Tip

Background: The preferable reconstructive surgical options for Allen type IV finger amputation is replantation. The viable alternate option is bone and nail bed graft repositioning on local flaps. The wider scope of this “graft reposition on flap” (GRF) technique was introspected.Methods: Fifteen patients who sustained type IV amputations of finger tip were operated between 2013 and 2017 by GRF technique. The results, range of motions, functional out come and its feasibility were analyzed and evaluated. A technical modification of GRF was also described within this series of patients.Results: All patients had good nail bed survival and well settled local flaps. Static two-point discrimination (2PD) was of 6.4 mm (average). 14/15 patients had an acceptable shortening of 4mm (average). Overall patients were happy after surgery and returned back to their work. All had excellent range of movements and 0 VAS. The follow up was 1 to 5 years (mean 2.8 years). Wound infection was seen in one patient whom after debridement developed gross shortening and thick nail. None developed nail deformity.Conclusions: The GRF provided an alternative option for Allen type IV amputations of finger tip. It can be well executed in all reconstructive surgical units and in those with a learning curve for replantations surgeries. The results of GRF were proportionate with the available surgical options in terms of appearance, function and outcomes.

Sign in / Sign up

Export Citation Format

Share Document