title: Surgical treatment of nail bed subungual exostosis.
abstract: BACKGROUND
  A subungual exostosis (SE) is a bony overgrowth that is permanently attached to the tip of the distal phalanx. Its pathology differs from osteocartilaginous exostoses in that it mainly involves the overgrowth of normal bone, which may present beneath the toenail or on the sides of the toe. This retrospective study aimed to report the results of surgical treatment when the diagnosis of SE was delayed; the condition was initially considered to be another pathology affecting a different nail or the terminal toe.
  
  
  METHODS
  A total of 17 patients (12 female, five male) were included in the study. All surgical resections were performed by the same surgeon using the same surgical technique, with the patient under digital anaesthesia. The patients were evaluated pre- and postoperatively (on Weeks 1 and 6, the first year, and the last follow-up visit) using the American Orthopaedic Foot and Ankle Society questionnaire and the Visual Analogue Scale score.
  
  
  RESULTS
  The patients underwent surgery for SE removal between December 2009 and October 2012. Their mean age was 21.3 ± 4.4 (range 14-29) years and the mean follow-up period was 27.1 ± 7.8 (range 18-45) months. Clinical or radiological recurrence was not observed in any of the patients during the follow-up period. Four patients had superficial infections, which were treated using appropriate antibiotic therapies.
  
  
  CONCLUSIONS
  As SE is an uncommon benign lesion, its diagnosis may be delayed. Radiography may be useful in obtaining a differential diagnosis.
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, Istanbul Medipol University, Turkey.
authors.forename: Melih
authors.initials: M
authors.lastname: Malkoc
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, Istanbul Medipol University, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Korkmaz
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, Istanbul Medipol University, Turkey.
authors.forename: Mert
authors.initials: M
authors.lastname: Keskinbora
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, Istanbul Medipol University, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Seker
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, Istanbul Medipol University, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Oltulu
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, Istanbul Medipol University, Turkey.
authors.forename: Ahmet Murat
authors.initials: AM
authors.lastname: Bulbul
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, Istanbul Medipol University, Turkey.
authors.forename: Ferhat
authors.initials: F
authors.lastname: Say
authors.affiliation: Department of Pathology, School of Medicine, Istanbul Medipol University, Turkey.
authors.forename: Aslı
authors.initials: A
authors.lastname: Cakir
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D002356:Cartilage / Q000000981:diagnostic imaging / Q000601:surgery; D003937:Diagnosis, Differential; D005096:Exostoses / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D009262:Nails / Q000601:surgery*; D009985:Orthopedics / Q000379:methods; D010147:Pain Measurement; D011184:Postoperative Period; D012008:Recurrence; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: nail bed; nail tip pathology; subungual exostosis; tumour