Subungual (Dupuytren's) exostosis

Area of Science:

• Orthopedics and Sports Medicine
• Pediatric Surgery
• Radiology

Background:

• Dupuytren's subungual exostosis is a rare osteochondral tumor impacting the distal phalanx in adolescents.
• This condition is frequently misdiagnosed due to a lack of awareness among medical professionals.

Purpose of the Study:

• To enhance awareness of Dupuytren's subungual exostosis.
• To outline accurate diagnostic methods and effective surgical treatments for this condition.

Main Methods:

• Retrospective case review of six pediatric patients diagnosed with subungual exostosis over three years.
• Diagnosis confirmed by clinical presentation (painful subungual mass) and radiographic evidence of exostosis.
• Surgical treatment involved complete excision of the lesion and overlying nailbed.

Main Results:

• Five patients who underwent complete surgical excision experienced a curative outcome.
• Two patients with prior incomplete excision experienced recurrence within three months.
• Accurate diagnosis and complete surgical removal are crucial for successful treatment.

Conclusions:

• Improved clinical and radiological awareness can prevent misdiagnosis of subungual exostosis.
• Complete surgical excision of the lesion is the recommended treatment to prevent recurrence and associated morbidity.
• This study highlights the importance of appropriate operative techniques for managing subungual exostosis.