Surgical treatment of subungual glomus tumors: Experience with lateral subperiosteal and transungual approaches

Abstract

Background: Nail bed deformity and tumor recurrence are the major complications of subungual glomus tumor surgery. Therefore, alternative methods to approach glomus tumors in the hand have been proposed in order to avoid further nail bed injury after surgical treatment. Methods: In this study, we report a series of 32 patients with glomus tumors in the subungual region of the hand, treated surgically with two different types of incisions. The clinical efficacy and safety of the surgical treatment of glomus tumors performed by the lateral subperiosteal or the transungual approaches were analyzed. Results: In transungual approach since the nail plate is extracted and the nail bed is incised, there is a high risk of postoperative nail deformity and late recovery. However, in lateral subperiosteal approach since only the skin lateral to the nail is incised without extracting nail plate and incising nail bed, the nail bed injury does not occur. Conclusion: As a result, early recovery occurs and postoperative nail deformity is unaccepted. The main advantages of lateral subperiosteal approach are reducing postoperative nail deformity and early recovery. However, not every glomus tumor is suitable for lateral subperiosteal approach. In peripherally located tumors, the lateral subperiosteal approach provides quick recovery of the cosmetic appearance and less deformation of the nail.