A novel management strategy for subungual exostosis

Subungual exostosis is a relatively uncommon benign bone tumour that mostly affects the toes of young people and can be a source of significant impact on health-related quality of life. Treatment consists of marginal excision and meticulous wound closure. We presented a case of subungual exostosis in the hallux of a young Caucasian girl. Once diagnosed, the lesion was completely excised leaving a sizable defect in the nail bed and skin folds. A pedicled vacuum assisted closure (VAC) device was used postoperatively in an attempt to minimise the tissue deficit. At 1-year follow-up, the nail had regrown and tissue reformed producing an optimal functional and cosmetic result with no recurrence. Postoperative wound complications in the setting of subungual exostosis are significant and a great variability exists in their appropriate management. We presented the novel use of the VAC device in the successful management of subungual exostosis.