Clinique Jouvenet, Capio - Ramsay Santé, 6 Square Jouvenet, 75016 Paris, France; Hôpital Privé Paul d'Egine, Capio - Ramsay Santé, 4 Avenue Marx Dormoy, 94500 Champigny sur Marne, France.
Hôpital Privé Paul d'Egine, Capio - Ramsay Santé, 4 Avenue Marx Dormoy, 94500 Champigny sur Marne, France.
Hand Surg Rehabil. 2024 Apr;43S:101607. doi: 10.1016/j.hansur.2023.10.001. Epub 2023 Oct 20.
Subungual glomus tumors arise from the glomus body of the digits. They are rare and benign and often in a single location. Their diagnosis relies on the typical clinical triad of symptoms and on imaging findings, mainly magnetic resonance imaging with gadolinium injection. Subungual tumors treatment is complete resection, essential for cure. The different surgical techniques aim to: a painless digit with normal range of motion and sensitivity, without nail deformity after tumour resection, and to recurrence prevention. They vary according to tumor location. Classic surgical approaches are: the nail unit sparing ones (para-ungual, lateral subperiosteal, periungual), and the nail unit non-sparing ones (all transungual approaches with nail bed splitting). In this paper, we review the literature for the different approaches describing the advantages and drawbacks of each of them. We also describe the author's preferred subperiosteal "shark mouth" flap containing the nail plate and the nail bed as a single unit. It can be performed whether the tumor is located centrally, peripherally, or under the germinal matrix with very satisfactory outcomes.
甲下血管球瘤起源于指（趾）部的血管球。它们是罕见的良性肿瘤，通常单发。其诊断依赖于典型的三联征症状和影像学表现，主要是钆增强磁共振成像。甲下肿瘤的治疗方法是完全切除，这是治愈的关键。不同的手术技术旨在实现：切除肿瘤后，手指无痛、运动和感觉正常、无指甲畸形，并且可以预防复发。这些技术根据肿瘤的位置而有所不同。经典的手术方法包括：保留甲单元的手术（甲旁、侧骨膜下、甲周）和不保留甲单元的手术（全部经甲床劈开的方法）。本文通过文献复习，对不同的手术方法进行了描述，阐述了它们各自的优缺点。我们还描述了作者推荐的包含甲板和甲床的骨膜下“鲨鱼口”皮瓣，该皮瓣可以在肿瘤位于中央、周围或生发基质下时进行，手术效果非常满意。
