Subungual nodular lesion of the big toe of the right foot.

Teenager, male, soccer player reports the presence of an hard nodular lesion at the big toe of his right foot. The lesion has had a slow growth and only in the last few months the patient reports pain in pressure and by walking. Before the surgery we required an x-ray that has confirmed the clinical suspicion of a subungual exostosis. After troncular anesthesia at the base of the hallux and the application of a tourniquet, we cut the peri-lesional skin progressing in a distal-proximal direction and progressively separate the nail bed from the underlying bone until to raise and to bend the nail bed and the nail plate in order to more easily treat the exostosis. We then used bone surgical instruments to eliminate exostosis. Finally the surgical wound was treated with hemostatic sponge that we covered with the bed and the nail plate repositioned and fixed in their natural seat with sutures.