title: Nail-preserving modified lateral subperiosteal approach for subungual glomus tumour: a novel surgical approach.
abstract: OBJECTIVE
  Glomus tumours are benign, vascular neoplasms arising from glomus body and are often found near the fingertips. Complete surgical excision of the tumour must be ensured to avoid its recurrence. Several surgical approaches for its excision have been described in the literature; however, most of the approaches are associated with nail deformity in the post-operative period or fail to offer a complete exposure of the tumour. We wish to share our experience with our described nail-preserving modified lateral subperiosteal approach, where on account of the distal curve over the pulp tip, we achieve a large flap yielding an excellent exposure of the tumour mass.
  
  
  METHODS
  We retrospectively evaluated 30 patients with subungual glomus tumour who were operated using this approach at a mean follow-up of 35.33 months. All patients were assessed for relief in the pre-operative symptoms, nail deformity, recurrence or any other complications.
  
  
  RESULTS
  All wounds healed well without any possible wound complications such as wound dehiscence, suture margin necrosis or infection. At the end of the follow-up, all patients were relieved of the pre-operative symptoms. There was no evidence of deformity of nail or fingertip. No patient had recurrence. All the operated fingers were functionally normal.
  
  
  CONCLUSIONS
  Nail-preserving modified lateral subperiosteal approach does not damage the nail bed or interosseous supports to the distal phalanx. It is a very simple, less time-consuming approach for the resection of subungual tumours, and we would like to recommend it to our fellow orthopaedic surgeons.
authors.affiliation: Department of Orthopaedics, All India Institute of Medical Sciences, Aurobindo Marg, New Delhi, 110029, India. drbhavukgarg@gmail.com.
authors.forename: B
authors.initials: B
authors.lastname: Garg
authors.affiliation: Department of Orthopaedics, All India Institute of Medical Sciences, Aurobindo Marg, New Delhi, 110029, India.
authors.forename: M V
authors.initials: MV
authors.lastname: Machhindra
authors.affiliation: Department of Orthopaedics, All India Institute of Medical Sciences, Aurobindo Marg, New Delhi, 110029, India.
authors.forename: V
authors.initials: V
authors.lastname: Tiwari
authors.affiliation: Department of Orthopaedics, All India Institute of Medical Sciences, Aurobindo Marg, New Delhi, 110029, India.
authors.forename: V
authors.initials: V
authors.lastname: Shankar
authors.affiliation: Department of Orthopaedics, All India Institute of Medical Sciences, Aurobindo Marg, New Delhi, 110029, India.
authors.forename: P
authors.initials: P
authors.lastname: Kotwal
mesh_terms: D000328:Adult; D005260:Female; D005918:Glomus Tumor / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000601:surgery*; D009262:Nails; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D055815:Young Adult
keywords: Approach; Excision; Glomus tumour; Lateral; Nail; Recurrence