Outcome of transungual surgical approach with synthetic nail shield in the treatment of digital glomus tumors: A retrospective study

Abstract

Glomus tumor is a benign neuromyoarterial tumor commonly found in the hand, particularly in the subungual region, that is removed only by surgery. Surgical excision leaves postoperative nail deformity and may cause a recurrence of subungual glomus tumors. A retrospective chart review was performed to assess the role of a synthetic nail shield in the prevention of postoperative nail deformity after transungual glomus tumor excision; the review was performed at a minimum of one year of follow-up of proven diagnosed 19 patients with digital glomus tumor between May 2011 and April 2016 in the orthopedic department in the university hospitals. All patients underwent surgical excision using transungual approach with a synthetic nail shield under digital nerve block anesthesia. Pain, cold intolerance, and complications were examined before and after surgery, and data were recorded. All patients had pain, tenderness, and cold intolerance, 12 patients (63.2%) had nail discoloration, and 3 patients (15.8%) had dystrophic changes. The tumors detached from surrounding tissues had an ovoid or round shape of 2–10 mm in size. Diagnosis was confirmed after pathological examination. In all patients, pain and cold sensitivity diminished. The mean follow-up period was 20.6 months, with no recurrences detected and improved nail appearance. No patient had postoperative nail deformity. Transungual approach followed by artificial coverage was an effective method for the treatment of glomus tumors without complications to the nail bed.

Keywords

• Glomus tumor
• Hand tumor
• Nail deformity
• Subungual tumor
• Transungual approach