Dehdashtian Amir, Amirlak Bardia
School of Medicine, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; and Department of Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas, Tex.
Plast Reconstr Surg Glob Open. 2016 Feb 16;4(2):e620. doi: 10.1097/GOX.0000000000000575. eCollection 2016 Feb.
The authors describe a case of retained sterile matrix in a 38-year-old Hispanic man with a history of remote trauma and soft-tissue coverage with a groin flap 13 years before presentation. The patient presented with a slowly enlarging, vertically growing dorsal thumb mass with occasional drainage. The patient had minimal functional impairment, and radiographic imaging showed a radiolucent mass projecting dorsally over the distal phalanx. Surgical exploration revealed an approximately 2 × 2 cm keratinized mass attached to a retained nail bed. The keratinized nail plate was removed, along with an ellipse of soft tissue around the draining tract. To the authors' knowledge, this case is the largest reported vertically growing, retained, and cornified nail bed with an unusual size and shape. Physicians should consider the possibility of retained nail plates in patients who present with unusual large growths after trauma or surgery.
作者描述了一例38岁西班牙裔男性患者，该患者有陈旧性创伤史，13年前曾行腹股沟皮瓣软组织覆盖术，现发现体内留存无菌基质。患者就诊时表现为右手拇指背侧肿物缓慢增大且呈纵向生长，偶有渗液。患者功能障碍轻微，影像学检查显示在远节指骨背侧有一透光肿物。手术探查发现一个约2×2 cm的角化肿物附着于留存的甲床。切除角化甲板及引流道周围的椭圆形软组织。据作者所知，该病例是报道中最大的纵向生长、留存且角化的甲床，其大小和形状均不寻常。对于创伤或手术后出现异常大肿物的患者，医生应考虑留存甲板的可能性。
