Liu Bin, Chen Weijian, Lu Liang
Department of Orthopedics, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei Anhui, 230001, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Oct 15;34(10):1294-1297. doi: 10.7507/1002-1892.202003035.
To investigate the feasibility and effectiveness of the distal curved incision approach of lunula in treating subungual glomus tumor in nail root.
Between March 2017 and October 2019, 16 patients (16 fingers) with subungual glomus tumor in nail root were treated. There were 2 males and 14 females with an average age of 35.3 years (range, 21-67 years). The disease duration ranged from 5 months to 17 years, with a median duration of 15 months. There were 6 cases of thumb, 3 cases of index finger, 2 cases of middle finger, 4 cases of ring finger, and 1 case of little finger. All of them showed typical "triad syndromes", and the cold sensitivity test and Love test were positive before operation. Each patient removed the nail, the tumor was exposed under the nail bed via the distal curved incision approach of lunula. After the tumor was removed completely, the nail bed was reducted without suturing. The self-made nail template was pressurized and fixed on the surface of the nail bed with suture. The conditions of nail bed healing, pain, and growth of nail were observed after operation.
All wounds of the nail bed with laceration healed by first intention. Postoperative pathological results confirmed the diagnosis of subungual glomus tumor in all the patients. All cases were followed up 3-26 months with an average of 15 months. The pain symptom disappeared and no obvious pain occurred during dressing change in all cases; and the cold sensitivity test and Love test were negative. The nails recovered smoothly with satisfactory appearance, and no obvious complications such as longitudinal ridge deformities or recurrences was observed.
The treatment of subungual glomus tumor in nail root via the distal curved incision approach is an effective method, which can easily operated, resect the tumor completely, protect the nail bed effectively, and also has a significant effect on preventing postoperative nail deformity.
探讨甲半月远侧弧形切口入路治疗甲根下血管球瘤的可行性及有效性。
2017年3月至2019年10月，收治16例（16指）甲根下血管球瘤患者。其中男性2例，女性14例，平均年龄35.3岁（21 - 67岁）。病程5个月至17年，中位病程15个月。拇指6例，示指3例，中指2例，环指4例，小指1例。均表现为典型的“三联征”，术前冷敏感试验及洛芙试验均为阳性。患者均拔除指甲，经甲半月远侧弧形切口入路在甲床下方暴露肿瘤。肿瘤完整切除后，甲床不缝合予以复位。用自制甲模板加压并用缝线固定于甲床表面。术后观察甲床愈合、疼痛及指甲生长情况。
甲床裂伤的所有伤口均一期愈合。术后病理结果均确诊为甲根下血管球瘤。所有病例均随访3 - 26个月，平均15个月。所有病例疼痛症状消失，换药时无明显疼痛；冷敏感试验及洛芙试验均为阴性。指甲恢复顺利，外观满意，未观察到明显并发症如纵嵴畸形或复发等。
甲半月远侧弧形切口入路治疗甲根下血管球瘤是一种有效的方法，操作简便，能完整切除肿瘤，有效保护甲床，对预防术后指甲畸形也有显著效果。
