León-Román Víctor Estuardo1,3*, López-Torres Irene Isabel2,3, Salas Quispe Alejandro Arturo1, Nuñez-García Ana1 and García- Prieto Esteban1
1Department of Traumatology and Orthopaedics Research, Villalba General Hospital, Carretera de Alpedrete a Moralzarzal, Madrid, Spain
2Fundación Jiménez Díaz Hospital. Av. Reyes Católicos, Madrid, Spain
3Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Calle Avenida de reyes católicos, Madrid (Spain)
*Corresponding Author: León-Román Víctor Estuardo, Department of Traumatology and Orthopaedics Research, Villalba General Hospital, Carretera de Alpedrete a Moralzarzal, Madrid, Spain.
Received: March 15, 2023; Published: April 10, 2023
Background: Subungual exostosis of the hallux is an osteochondral tumor that causes pain and deformity, requiring surgical resection in many cases. Although several specialities treat this tumor, orthopaedic surgeons seem to be poorly versed in its management. Several removal techniques have been described, all of which are open, aggressive and with high complication rates. We present a percutaneous removal technique with minimal soft tissue injury and a low complication rate. Surgical technique: 12-year-old male presented with a painful exostosis of the hallux with severe deformity. Percutaneous forefoot surgery was used to marginally resect the lesion preserving the integrity of the nail matrix. With millimetric wounds, the tumor is detached from its bed, its base was resected and burned. The patient had no complications, unpainful recovery and no recurrences within two years.
Discussion: Multiple techniques have been described for the removal of this exostosis. The main difference between them is the way the wound is closed, ranging from healing by secondary intention to direct suturing between the skin and the nail. The complication rate is 40%, the most frequent being residual nail deformity, infection and recurrence. Our technique applies percutaneous surgery, performing minimal damage to the soft tissue and nail bed while achieving the marginal excision of the tumor with debridement of the implantation bed.
Conclusion: The excision of the subungual exostosis of the hallux can be performed safely and with a low complication rate through percutaneous surgery, ensuring minimal incisions with little soft tissue damage.
Keywords: Subungual Exostosis of the Hallux; Percutaneous Surgical Technique; Forefoot Surgery; Tumor of the Hallux
Citation: León-Román Víctor Estuardo. “Subungual Exostosis of the Hallux: A Solution Through Percutaneous Surgery”.Acta Scientific Orthopaedics 6.5 (2023): 22-25.
Copyright: © 2023 León-Román Víctor Estuardo. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.