Abstract：
Background: Glomus tumour is a painful small tumour of the glomus body commonly located under the nail bed. The aim of this study is to evaluate the correlation of clinical diagnosis with MRI findings, determine the prevalence of the tumour at different subungual locations and determine the differences in outcomes (if any) between a longitudinal and a transverse nail bed incision for excision of the tumour. Methods: This retrospective study of 56 subungual glomus tumour was conducted from May 2010 to December 2021. Data with regard to gender, age at presentation, digit involved, presenting symptoms, duration of symptoms, clinical signs, need for MRI, anatomical location, surgical approach (longitudinal versus transverse), histopathology result, period of follow-up and complications were recorded. Results: All 56 (100%) patients presented with classic triad of symptoms. The average duration of symptoms was 52.9 months (range: 3-204 months). Eleven (20%) tumours were in the sterile matrix, 38 (68%) at the junction of sterile and germinal matrix and 7 (12%) in the germinal matrix. The tumours were excised through the longitudinal incision in 31 (55.3%) patients and transverse incision in 25 (44.7%). One (1.8%) tumour was intraosseous that was diagnosed intraoperatively and excised successfully. Average follow-up was 35.4 months (range: 6-120 months). There was no difference in outcomes (pain or nail deformity) between the two incisions. One patient (1.8%) has persistent pain that was due to a missed satellite lesion in the same digit. This was excised later with resolution of symptoms. There were no recurrences and all patients were cured after excision of tumour. Conclusions: Diagnosis of glomus tumour is usually clinical, and most are located at junction of sterile and germinal matrix. Tumour can be excised either by longitudinal or transverse nail bed incisions without any change of treatment outcome. Level of Evidence: Level IV (Therapeutic).
摘要：
背景：血管球瘤是一种痛苦的血管球体小肿瘤，通常位于甲床下方。这项研究的目的是评估临床诊断与MRI检查结果的相关性，确定肿瘤在不同甲下位置的患病率，并确定纵向和横向甲床切口切除肿瘤的结果差异（如果有）。方法：本研究于2010年5月至2021年12月进行了56例甲下血管球瘤的回顾性研究。性别数据，介绍时的年龄，涉及数字，出现症状，症状持续时间，临床体征,需要核磁共振,解剖位置,手术入路（纵向与横向），组织病理学结果,记录随访时间和并发症。结果：所有56例（100％）患者均表现为经典三联征。平均症状持续时间为52.9个月（范围：3-204个月）。11例（20%）肿瘤在无菌基质中，在无菌和生发基质的交界处38（68％），在生发基质中7（12％）。肿瘤通过纵向切口切除31例(55.3%)，横向切口切除25例(44.7%)。一个（1.8％）肿瘤是骨内肿瘤，在术中诊断并成功切除。平均随访35.4个月(6～120个月)。两个切口之间的结果（疼痛或指甲畸形）没有差异。一名患者（1.8％）的持续性疼痛是由于同一手指的卫星病变遗漏所致。后来切除，症状消退。没有复发，所有患者在切除肿瘤后均治愈。结论：血管球瘤的诊断通常是临床诊断，大多数位于无菌和生发基质的交界处。可以通过纵向或横向甲床切口切除肿瘤，而不会改变治疗结果。证据级别：IV级（治疗）。
