The Influence of Clinical Factors on Treatment Outcome and a Recurrence of Surgically Removed Protruded Subungual Osteochondroma and Subungual Exostosis.

BACKGROUND: Subungual exostosis (SE) and subungual osteochondroma (SO) are benign solitary lesions that grow from the distal phalanx. The mass itself is typically painless, but pressure on the nail plate can result in pain and deformity of the involved digit. Tumors can be correctly diagnosed based on clinical, histological and radiographic appearance alone. Surgical resection of SE/SO is typically curative, with a small risk of recurrence. METHODS: The study was retrospective and observational, involving 74 patients with subungual SE/SO. The surgical procedure consisted of the removal of the tumor from the dorsal approach under digital anesthesia. The procedure was assessed using a questionnaire and photo documentation after a minimum of 6 months after surgery. RESULTS: A total of 85% of respondents were satisfied with the procedure. Nearly 80% of patients rated the cosmetic effect as good or very good. Young age and pain intensity after surgery showed statistically significant associations with worse satisfaction. Age < 18 was associated with recurrence. CONCLUSIONS: Worse satisfaction is strongly associated with recurrence. Gender, duration of symptoms, pain before surgery and tumor size and destruction of the nail plate had no significant effect on recurrence. The technique using burr appeared to be a more effective treatment.

Efficacy of a tip of the big toe remodeling in the distal nail embedding with bone overgrowth of the distal phalanx.

INTRODUCTION: Distal nail embedding due to hyponychium hypertrophy can be caused by traumatic or surgical avulsion of the nail. As a consequence of these changes, the nail plate is blocked through the deformed tip of the toe. Changes that occur at the tip of the big toe are due to bone growth on the dorsal surface of the distal end of the distal phalanx. This study aimed to present a surgical technique for the treatment of hypertrophy of the tip of the toe and evaluate its effectiveness. MATERIAL AND METHODS: The surgical technique involved remodeling of the tip of the big toe, with removal of the hypertrophied bone of the distal phalanx. The procedure was assessed by using a questionnaire. RESULTS: We included the 108 distal embedded nails. A total of 85% of respondents were satisfied with the procedure. Nearly 80% of patients rated the cosmetic effect as good or very good. CONCLUSIONS: The technique was an effective treatment and increased the quality of life of those with disorders of nail growth associated with hypertrophy of the tip and hyponychium, with bone overgrowth.

Recurrence and satisfaction with sutured surgical treatment of an ingrown toenail.

BACKGROUND: In the present study, we investigated the satisfaction of patients following sutured surgical treatment of an ingrown toenail with nail preservation and without matricectomy. MATERIALS AND METHODS: This study was retrospective. In total, 37 consecutive patients underwent 54 ingrown toenail surgeries. The clinical outcomes, satisfaction of surgery, recurrence rates and the duration of symptoms were compared. RESULTS: Recurrence with the technique was very low (one toenail). The mean overall satisfaction score on the surgical satisfaction questionnaire was 86.4 ± 10.4 and extended with a modified esthetic subscale (88 ± 10). The mean pain subscale score was the lowest at 77.1 ± 16.8, while the subscale returns to baseline scored 80.9 ± 16.4, the subscale global satisfaction scored 98.1 ± 7.2 and the subscale esthetics scored 92.1 ± 15. CONCLUSION: Our suturing technique was associated with low recurrence and high satisfaction rates. We showed that higher levels of satisfaction with the treatment were achieved in men, and the duration of symptoms was no longer than one year.