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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE

A Journal on Physiopathology and Surgery of the Foot


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Chirurgia Del Piede 2001 June;25(2):81-4

language: Italian

Treatment of foot subungueal exostosis

Rosa M. A., Galli M., Tafuro L., Proietti L.


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Background. Subungueal exostosis of the foot is a rare disease usually affecting the toe.
Methods. Surgery is the treatment of choice by means of a resection of the lesion at its implant base. Patient's satisfaction is influenced both by the healing and the final cosmetic outcome. From 1990 to 1999, 13 patients with subungueal exostosis were treated at the Catholic University of Rome, with a mean age of 26,7. In 6 cases total onychectomy was necessary, in the other patients the whole nail or a part of it was saved.
Results. The mean follow-up was 21 months. Recurrence was never observed. In patients with subungueal exostosis of the 2nd or 3th finger, the nail never regenerated after his ablation. In the first finger the complete recover of the nail was observed within 4 to 6 months. In only one case the nail resulted dysmorphic. In our experience direct subungueal approaches gave the best cosmetic results. Total onychectomy may cause the lack of nail regeneration.
Conclusions. Partial onychectomy is recommended in those cases where the lesion is localised in the proximal part of the phalanx.

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