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The Impact of Subungual Osteochondroma Deformans on Severely Mycotic toenails

Journal of Cosmetics, Dermatological Sciences and Applications 2019年第1期9卷 56-65页

作者： Christopher Brian Stewart Maryellen Ann Waltz Central Virginia Foot & Ankle Laser Center Charlottesville VA USA

Background: We examined 94 toenails exhibiting clinical signs of severe onychomycosis taking into account multiple contributing factors, not the least of which was Subungual Osteochondroma Deformans (SOD). We hypothesize that SOD plays a significant role in both the etiology and treatment of onychomycosis. Methods/Results: A retrospective post-treatment outcome analysis was performed comparing two groups of severely mycotic toenails. The first group of 25 fungal nails showed 54.31% improvement following treatment by both surgical nail avulsion and a 1064 YAG laser-based Nail Restoration algorithm. The second group of 69 fungal nails was not only treated using the same nail avulsion/laser-based algorithm but was also evaluated for SOD lesions which were surgically removed when present, resulting in 95.31% improvement. The overall incidence of SOD lesions in the second group of severely mycotic toenails was 73.91%. Conclusion: We submit that at 73.91% Subungual Osteochondroma Deformans has an under-reported and under-appreciated association with toenail fungus. Generally, we find that our success rates in treating severe toenail fungus using our laser-based Nail Restoration Protocols are much higher when SOD lesions are surgically removed.

关键词： Subungual Osteochondroma Deformans Onychomycosis Laser toenail Topical Surgery Bone Spur

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Ingrowing Nail Correction by Advancing Composite Flap of the Nailbed and Periosteum—A Simple and Effective Technique

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Modern Plastic Surgery 2014年第2期4卷 26-31页

作者： Adil Mohammed Hashish Medhat Emil Habib Said Al-Busaidi Department of Plastic Reconstructive and Craniofacial Surgery Khoula Hospital Muscat Sultanate of Oman

Ingrowing toenails are common particularly in young adults. They usually result in a prolonged period of discomfort or pain that is sufficient to interfere with working and social activities. Apart from the toes, ingrowing nails can affect the fingers as well. Surgery is still the mainstay of treatment. A number of techniques have been described in the literature. But in all there is a high recurrence rate and sometimes the cosmetic result is not acceptable. In this article we describe our technique of surgical management of ingrowing nails of the toes and fingers. The technique involves excision of a part of the lateral nail fold and raising a composite flap consisting of the nail bed and the underlying periosteum which is then advanced. 105 cases were operated using this technique with very good postoperative results.

关键词： Ingrowing toenail Fingernail Composite Flap Nailbed

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