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Subungual Exostosis and Hematoma, Sports Medicine

Daniel C. Herman, MD, PhD, FAAPMR, FACSM, CAQSM and Glenn H. Sapp, II, MD Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Subungual exostosis: a chronic, benign, and osteocartilaginous growth from the distal phalanx’s terminal tuft that commonly causes pain and/or deformity of the nail

  • Subungual hematoma...

DIAGNOSIS

HISTORY

  • Subungual exostosis: typically weeks to months history of toenail pain, a localized mass or swelling in the toenail, or shoe wear discomfort. Previous history may include trauma or in...

TREATMENT

  • Subungual exostosis:

    • Excision of the tumor

  • Subungual hematoma:

    • Immediate elevation and application of ice or immersion in ice water may reduce pain and bleeding.

    • An acute subungual hematoma can ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Further evaluation with radiographs (exclude exostosis) and possibly a biopsy are required when a suspected subungual hematoma does not grow out distally as the n...

REFERENCES

1
DaCambra MP, Gupta SK, Ferri-de-Barros F. Subungual exostosis of the toes: a systematic review. Clin Orthop Relat Res.  2014;472(4):1251–1259.
2
Cordoro KM, Ganz JE. Training room manag...

CLINICAL PEARLS

  • Remember that not all dark patches under the nail are subungual hematomas. Consider the diagnosis of melanoma and other tumors when the history of trauma and the physical examination a...

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