CORR Insights^®: Subungual Exostosis of the Toes: A Systematic Review

Excerpt

As an orthopaedic oncologist in an average-sized city, I treat just about every sort of lump and bump from head to toe in babies up to nonagenarians. One of the bone diseases I occasionally see is subungual exostosis. While my residency and orthopaedic oncology fellowship prepared me well to handle bone- and soft-tissue malignancies, along with many benign tumors, I do not recall having seen a single subungual exostosis during my training. These cases often are referred to me by podiatrists. In their systematic review, DaCambra and colleagues detail the current state of understanding for subungual exostosis. In 1996, Davis and Cohen [3] previously reported on 312 patients comprehensively culled from the literature between 1857 and 1994. DaCambra and colleagues have taken a different approach from Davis and Cohen, reviewing only series that included 10 or more patients, resulting in a review of 13 manuscripts totaling 287 cases between 1980 and 2005. Of these 13 manuscripts, three were reported in orthopaedic and dermatology journals respectively, with only one each in foot/ankle, radiology, trauma, pathology, plastics, podiatry, and general journals. This is a condition that clearly falls at the fringes of multiple specialties, and therefore is not concentrated within any single specialty. That is a problem. As for many other relatively uncommon fringe conditions evaluated and treated by many different types of physicians, our ability to gather and advance meaningful information and treatment is limited. …