甲下外生骨疣1例

A Case of Subungual Exostoses Treated with Replanting Deck

患者女,20岁,因左足拇趾远端肿物伴触痛1年就诊。1年前左足拇趾外伤后出现绿豆大肤色结节,逐渐增大,触痛明显。X线检查,左足第一趾屈侧骨质增生物,从远端指骨突出并与之连续的小梁骨的生长,具有完整的明确的皮质边缘。远端指骨未发现破坏性变化,境界清楚。诊断为甲下外生骨疣。予以肿物祛除后,修补甲床、回植甲板。术后组织病理示:纤维软骨层中可见增生活跃的细胞,符合甲下外生骨疣。术后3个月复诊,指甲部分长出,缝线处有触痛;术后6个月复诊,指甲生长超过甲床面积1/2,触痛减轻;术后8个月复诊,趾甲恢复外形,无触痛。

A 20-year-old female patient presented with a one-year history of a mass on the distal toe of the left foot with tenderness.One year ago,after the left foot trauma to the big toe,mung bean nodules with skin color gradually increased,and the tenderness was obvious.X-ray examination showed that the bone hyperplasia on the flexor side of the first toe of the left foot,which protruded from the distal phalanx and continued with the trabecular bone,had a complete and clear cortical edge.No destructive changes were found in the distal phalanx,and the state was clear.It was diagnosed as exostoses under the nail.After removing the tumor,the nail bed was repaired and the deck was replanted.Postoperative histopathology showed hyperplasia of active cells in the fibrocartilage layer,which was in line with exogenous bone warts under the nail.Follow up after three months operation showed that the nail part grew and there was tenderness at the suture;six months after the operation,the nail growth exceeds 1/2 of the nail bed area,and the tenderness was reduced;eight months after the operation,the toenails recover shape,no tenderness.