摘要
目的探讨应用经甲半月以远弧形切口治疗指甲根部甲下血管球瘤的可行性及疗效。方法2017年3月—2019年10月收治16例(16指)指甲根部甲下血管球瘤患者。其中男2例,女14例;年龄21~67岁,平均35.3岁。病程5个月~17年,中位病程15个月。拇指6例,示指3例,中指2例,环指4例,小指1例。均表现为典型"三联征";术前冷敏感试验和Love试验均为阳性。患者均行全甲板拔除,经甲半月以远弧形切开甲床暴露瘤体,完整切除瘤体后,原位复位甲床不予以缝合,制作甲模板并原位回植,缝合加压固定。术后随访观察甲床愈合、疼痛、指甲生长等情况。结果术后患者切口均Ⅰ期愈合,术后病理检查均提示为甲下血管球瘤。所有患者均获随访,随访时间3~26个月,平均15个月。患指疼痛症状均消失,冷敏感试验和Love试验均为阴性;换药期间无明显疼痛。新生指甲平整光滑、外观满意,无明显纵嵴畸形等并发症发生;随访期间无1例复发。结论应用甲半月以远弧形切口治疗指甲根部甲下血管球瘤,操作简便、肿瘤切除彻底,术后复发率低,可有效保护甲床,预防术后指甲畸形,是一种有效手术方法。
Obejective To investigate the feasibility and effectiveness of the distal curved incision approach of lunula in treating subungual glomus tumor in nail root.Methods Between March 2017 and October 2019,16 patients(16 fingers)with subungual glomus tumor in nail root were treated.There were 2 males and 14 females with an average age of 35.3 years(range,21-67 years).The disease duration ranged from 5 months to 17 years,with a median duration of15 months.There were 6 cases of thumb,3 cases of index finger,2 cases of middle finger,4 cases of ring finger,and1 case of little finger.All of them showed typical"triad syndromes",and the cold sensitivity test and Love test were positive before operation.Each patient removed the nail,the tumor was exposed under the nail bed via the distal curved incision approach of lunula.After the tumor was removed completely,the nail bed was reducted in situ without suturing.The self-made nail template was pressurized and fixed on the surface of the nail bed with suture.The conditions of nail bed healing,pain,and growth of nail were observed after operation.Results All wounds of the nail bed with laceration healed by first intention.Postoperative pathological results confirmed the diagnosis of subungual glomus tumor in all the patients.All cases were followed up 3-26 months with an average of 15 months.The pain symptom disappeared and no obvious pain occurred during dressing change in all cases;and the cold sensitivity test and Love test were negative.The nails recovered smoothly with satisfactory appearance,and no obvious complications such as longitudinal ridge deformities or recurrences was observed.Conclusion The treatment of subungual glomus tumor in nail root via the distal curved incision approach is an effective method,which can easily operated,resect the tumor completely,protect the nail bed effectively,and also has a significant effect on preventing postoperative nail deformity.
作者
刘彬
陈伟健
鹿亮
LIU Bin;CHEN Weijian;LU Liang(Department of Orthopedics,the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital),Hefei Anhui,230001,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2020年第10期1294-1297,共4页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
甲下血管球瘤
甲半月
甲模板
Subungual glomus tumor
lunula
nail template