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Definition A diabetic foot ulcer (DFU) is a chronic, non-healing wound that develops in individuals with diabetes. It typically occurs on pressure-bearing areas such as the heel, metatarsal heads, or hallux, and carries a high risk of infection and amputation.Pathophysiology • The development of DFUs can be explained by four interconnected mechanisms: neuropathy, ischemia, infection, and impaired wound healing. • Neuropathy is the most common factor. Sensory neuropathy reduces pain perception,...
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Autologous Microfractured and Purified Adipose Tissue for Arthroscopic Management of Osteochondral Lesions of the Talus
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A soccer player with a sore toe: recognizing subungual osteochondromas.

G P Rajan1, R Zellweger, O Trentz

  • 1ENT Surgery Department, University Hospital, Zurich, CH. gunesh.rajan@orl.usz.ch.

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Subungual osteochondromas, often mistaken for sports injuries, can develop after trauma. Early diagnosis via X-ray and surgical removal ensure excellent recovery for this rare bone condition.

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Radiology

Background:

  • Subungual osteochondromas are rare bone tumors typically presenting under the nail.
  • Unlike typical osteochondromas, they may result from trauma rather than developmental errors.
  • Misdiagnosis is common, particularly when presenting as a sports injury, leading to undertreatment.

Purpose of the Study:

  • To highlight the distinct etiology and diagnostic challenges of subungual osteochondromas.
  • To emphasize the role of radiographic imaging in diagnosis.
  • To present an effective surgical treatment and its outcomes.

Main Methods:

  • Case report of a 20-year-old soccer player with a subungual osteochondroma of the great toe.
  • Diagnostic imaging using X-rays to confirm bone involvement.
  • Surgical resection with periosteal realignment.

Main Results:

  • X-ray confirmed a subungual osteochondroma in the patient's great toe, consistent with trauma.
  • Radical, anatomic resection of the symptomatic osteochondroma was performed.
  • The patient experienced an excellent functional outcome after surgery.

Conclusions:

  • Subungual osteochondromas require a high index of suspicion, especially after trauma in athletes.
  • X-rays are crucial for differentiating these lesions from other injuries.
  • Surgical excision with appropriate realignment provides a definitive and effective treatment with excellent functional results.