Comparison of the forearm rotation restriction capacities of four upper-extremity immobilization methods: there is no difference between single and double sugar tong splinting.

BACKGROUND: The aim of this study was to compare the effects of four different immobilization methods [single sugar tong splint (SSTS), double sugar tong splint (DSTS), short arm cast (SAC), and long arm cast (LAC)] commonly used for restricting forearm rotation in the upper extremity. METHODS: Forty healthy volunteers were included in the study. Dominant extremities were used for measurements. Basal pronation and supination of the forearm were measured with a custom-made goniometer, and the total rotation arc was calculated without any immobilization. Next, the measurements were repeated with the SAC, LAC, SSTS and DSTS. Each measurement was compared to the baseline value, and the percentage of rotation restriction was calculated. RESULTS: The most superior restriction rates were observed for the LAC (p = 0.00). No statistically significant difference was detected between the SSTS and DSTS in terms of the restriction of supination, pronation or the rotation arc (p values, 1.00, 0.18, and 0.50, respectively). Statistically significant differences were not detected between the SAC and the SSTS in any of the three parameters (p values, 0.25; 1.00; 1.00, respectively). When the SAC and DSTS were compared, while there was no significant difference between the two methods in pronation (p = 0.50), a statistically significant difference was detected in supination (p = 0.01) and in the total rotation arc (p = 0.03). CONCLUSION: The LAC provides superior results in restricting forearm rotation. The SAC and SSTS had similar effects on forearm rotation. The DSTS, which contains, in addition to the SSTS, a sugar tong portion above the elbow, does not provide additional rotational stability.

Scabies infestation might predispose surgical site infection: Case report.

INTRODUCTION AND CLINICAL IMPORTANCE: Human scabies is a contagious skin condition caused by the Sarcoptes scabiei mite, leading to skin damage and subsequent mechanical irritation from scratching. This impaired skin integrity predisposes individuals to skin infections. While the association between scabies and skin infections caused by Staphylococcus aureus and Streptococcus pyogenes is well-documented, there is limited literature on the risk of surgical site infections in such cases. CASE PRESENTATION: This case report aims to explore this risk by presenting a case of surgical site infection caused by Streptococcus pyogenes following surgery for a complex elbow injury in a patient with scabies infestation. DISCUSSION: Scabies infestation leads to direct spread of bacteria and contributes to bacterial infection. Furthermore, complement inhibition and dysbiosis induced by the scabies may facilitate the occurrence of these bacterial infections. CONCLUSION: Skin infections are frequently encountered in scabies infestations. Preferred incision should be evaluated meticulously before surgery. Further studies are needed to reach a definitive conclusion on this subject.

A comparison of two immobilization methods in the conservative treatment of pediatric distal forearm fractures: Long arm cast versus single sugar-tong splint.

OBJECTIVES: The aim of this study was to compare the results of single sugar-tong splint (SSTS) and long arm cast (LAC) as an immobilization method in pediatric distal forearm fractures. PATIENTS AND METHODS: Between January 2016 and December 2019, a total of 186 pediatric patients (143 males, 43 females; mean age: 10.3±3 years; range, 4 to 15 years) with distal forearm fractures were retrospectively analyzed. The patients were divided into two groups according to the immobilization method: SSTS group (n=74) and LAC group (n=112). All patients were evaluated at the time of admission, immediately after the reduction, and at one, two, and four weeks. Sagittal and coronal plane angulations and translation percentages of the radius at each visit were calculated. Alterations in coronal angle, sagittal angle, sagittal translation and coronal translation were calculated by subtracting the measurements after reduction from the measurements at four weeks. RESULTS: Both groups were comparable in terms of demographic characteristics, fracture localization, and side of injured extremity. There was a statistically significant difference only in the sagittal angulations in the first (LAC: 4.7; SSTS: 6.5; p=0.009) and second week (LAC: 5.3; SSTS: 6.8; p=0.024). The rest of radiological measurements were comparable. In the LAC group, seven patients had re-intervention (three manipulations, four surgeries) and in the SSTS group, three patients had re-intervention (two manipulations, one surgery) (p=0.657). CONCLUSION: Our study results suggest that SSTS and LAC are comparable in terms of radiological results and need for re-intervention as an immobilization method of pediatric distal forearm fractures.

Evaluation of Clinical and Radiological Results of Humeral Diaphyseal Fractures with Treated Sarmiento Brace.

Aim In our study, we aimed to evaluate the duration and rate of the union of adult humerus diaphysis fractures treated with a functional brace. Methods Forty-six adult patients admitted to our hospital with humeral diaphyseal fracture between January 2010 and April 2014 and treated with a functional brace were evaluated retrospectively. The demographic data, fracture type, level of fracture, and presence of bone union of the patients were evaluated from clinic records. The Disabilities of the Arm, Shoulder and Hand (Quick-DASH) questionnaire score of the patients was registered for patients and analyzed, and its correlation with parameters such as patient age and fracture bone union time was evaluated. Results It was observed that of the patients with the mean age of 45.5 years, six (13.6%) had non-union and five had delayed bone union (10.86%). Three (6.5%) patients had radial nerve injury, and all recovered without sequelae. Out of the patients with the bone union, 12 (30%) had an angulation above give degrees, and 3 (7.5%) had radiological shortness. The mean Quick-DASH score was 6.7, and there was no statistically significant correlation with parameters such as fracture type, level, angulation, radiological shortness and radial nerve involvement (p>0.05). Conclusions A functional brace is a good treatment choice with low complication rates and has satisfactory bone union rates in humerus diaphyseal fractures.

Long-term results of primary repair of combined cuts on the median and ulnar nerves in the forearm.

BACKGROUND: The objective of this clinical study was to evaluate sensory and motor functions in the later period following primary repair of combined injuries of the ulnar and median nerves in the forearm at proximal, middle, and distal levels. METHODS: Later period sensory evaluation of ulnar and median combined cuts was performed using two-point discrimination and monofilament tests. On the other hand, motor evaluation was performed by determining dorsal palmar interosseus strength for the ulnar nerve and abductor pollicis brevis muscle strength for the median nerve. Cold intolerance, object recognition, and weight discrimination were also reviewed. RESULTS: In total, 26 patients with ulnar-median combined cut and aged between 5 and 59 years were included in this study. Although no deficiency was observed in the sensory functions of any of the patients, a decrease in tactile sensation was detected in the median sensory region in 12 (46%) patients and in the ulnar sensory region in 7 (26%) patients. The most significant loss in terms of motor functions was detected in the opposition pinch strength. Two patients developed claw hand and two showed joint contracture. CONCLUSION: Ideal treatment for peripheral nerve injuries should be primary repair. Restoration of the motor function in the median nerve is relatively easier than that in the ulnar nerve. No significant difference was observed in terms of sensory function. An alternative is needed for primary repair because of lack of motor function in proximal ulnar incisions. There is no standardization of tests performed for peripheral nerve repair.

Comparison of single event vs multiple event soft tissue surgeries in the lower extremities with cerebral palsy.

UNLABELLED: In children with spasticity of multiple muscle groups, the need for repeat surgical interventions increases with advancing age. AIM: The present study aimed to investigate retrospectively whether there are any clinical and functional differences between single-event multilevel surgeries and multiple surgical events at a single level. METHOD: The medical records of 109 patients with cerebral palsy (CP) were used. The patients, who met the inclusion and exclusion criteria, were assigned into following 4 groups based on the surgical procedures. The Gross Motor Function measure-88 (GMFCS) and Functional Independence Measure for Children (WeeFIM) were used for assessments. RESULTS: When compared to groups, there was no significant difference. This study showed that both surgical techniques resulted in improvements in GMFCS and WeeFIM levels.

Effects of platelet-rich plasma on nerve regeneration in a rat model.

OBJECTIVE: The aim of this study was to determine whether platelet-rich plasma has a regenerative effect on a sciatic nerve injury model in rats. METHODS: A sciatic nerve cut model was created in 24 nerves of 12 rats. All nerves were repaired with epineural sutures by the same surgeon. Rats were randomly divided into two groups; platelet-rich plasma was applied to the injury site in the platelet-rich plasma group and saline only to the same area in the control group. Motor and electromyographic assessments were performed at the end of 12th postoperative week and all rats were euthanized for histological specimens. RESULTS: Motor recovery was significantly better in the platelet-rich plasma group than the control group. The differences in electromyographic and histomorphometric findings between the groups were significant (p<0.05). CONCLUSION: Our experimental study demonstrated positive effects of platelet-rich plasma on nerve regeneration.

The effectiveness of tetanus toxin on sciatic nerve regeneration: a preliminary experimental study in rats.

OBJECT: The purpose was to investigate the effects of local tetanus toxin (TeTx) application on sciatic nerve regeneration following a rat model of transection injury. METHODS: After both sciatic nerves were transected and repaired with three epineural sutures, 12 male Wistar albino rats were divided into two groups. 0.25 ml (2.5 flocculation units) TeTx was injected into a piece of absorbable gelatin sponge in TeTx group. In controls, 0.25 ml saline injected. Assessments were performed by using climbing degrees, compound muscle action potentials (CMAPs) and histological parameters (axon number and axonal diameter) 12th week. RESULTS: CMAPs amplitudes were 11.6 ± 4.7 mV and 1.4 ± 1.3 mV in gastrocnemius and interdigital muscles in TeTx group (5.8 ± 2.4 mV and 0.2 ± 0.1 mV, P < 0.05). Climbing degrees were significantly different (61.6 ± 1.7 vs. 38.3 ± 2.6, P < 0.05). Total axon numbers were higher (1341.1 ± 57.3 vs. 877.5 ± 34.9, P < 0.05) and the mean axon diameter was smaller (4.2 ± 2.1 vs. 2.5 ± 1.9, P < 0.05) in the TeTx group. CONCLUSION: This preliminary study firstly demonstrated the effectiveness of TeTx on nerve repair in experimental sciatic rat model based on functional, electromyographic and histological parameters.

Retrospective comparison of external fixation versus volar locking plate in the treatment of unstable intra-articular distal radius fractures.

The aim of this study is to compare the radiological and functional outcomes of open reduction and volar locking plates versus external fixation (EF) in the treatment of unstable intra-articular distal radius fractures. In this retrospective comparative study, 69 of 80 patients who underwent an operation for AO/ASIF C1, C2 and C3 distal radius fractures were assessed. Functional evaluation was performed using the Gartland-Werley scoring system and the PRWE scale, and wrist range of motion and grip strength was also measured. For the radiological assessment, radial inclination, volar tilt, radial length, ulnar variance, and articular step-off were compared. The range of movement was better for all parameters in the volar plate group, but only wrist flexion and pronation range differed significantly between the groups (p = 0.037 and p = 0.014, respectively). With the exception of better subjective functional results in the volar plate group, the differences were not significant. With respect to radiological evaluation, all parameters were better in the volar plate group, but only radial inclination and articular step-off were significantly better (p = 0.018 and p = 0.029, respectively). In the volar plate group, two patients had carpal tunnel syndrome and one patient had regional pain syndrome. In the external fixator group, six patients had superficial pin tract infection, two patients had sensory branch injury, and four patients had regional pain syndrome. Volar locking plate fixation appeared as a dependable method for the treatment of intra-articular distal radius, with lower complication rates. On the other hand, EF remains a suitable surgical alternative for these fractures, with easy application and acceptable results.

The effect of excisional arthroplasty with palmaris longus tendon on carpal height ratio in Stage 3 Kienböck's disease.

OBJECTIVE: Treatment methods in Kienböck's disease remain controversial despite the long-term awareness of the disease by orthopedic surgeons. Currently, excisional arthroplasty with a palmaris longus tendon ball is one of the most frequently used treatment methods. The aim of this study was to evaluate the long-term results of thirty-eight patients who had been treated with excisional arthroplasty and palmaris longus tendon ball, as well as the effect of this method on carpal height. METHODS: In this study, we retrospectively evaluated 38 patients (mean age: 30.4 years; range: 17-64 years) with Stage 3 Kienböck's disease who underwent excisional arthroplasty between 1978 and 2008. According to the Lichtman classification, 8 patients were classified as Stage 3a and 30 patients were classified as Stage 3b in Kienböck's disease. The mean duration of follow-up after surgery was 81.3 (range: 25 to 264) months. The outcomes were evaluated with joint range of motion, grip strength and functional assessment of Nakamura and radiographic changes in carpal height. RESULTS: According to the Nakamura's scoring system the results were excellent in 22 (57.9%) patients, good in 13 (34.2%) and moderate in 3 (7.9%). Comparison of pre and postoperative range of motion of the wrist revealed an average increase in wrist extension of 10° (p<0.05), and an average decrease in ulnar deviation of 4° (p<0.05) after the operation. No significant difference was observed when comparing other joint range of motion parameters. Dynamometric grip strength measurements revealed significant differences between the healthy and operated sides (67.6 kgf vs. 45.9 kgf, respectively; p<0.05). The decrease in the revised carpal height ratio were significant. CONCLUSION: According to patient satisfaction rate and clinical results, the outcome of excisional arthroplasty with palmaris longus tendon ball in Stage 3 Kienböck's disease is satisfactory. However, carpal height reduction and development of degenerative changes may be expected in long-term follow-up.

[Extensor indicis proprius transfers for extensor pollicis longus ruptures secondary to rheumatoid arthritis]. / Romatoid artritte ekstansör pollisis longus kopmalari için ekstansör indisis proprius transferi.

OBJECTIVES: We evaluated the results of extensor indicis proprius (EIP) to extensor pollicis longus (EPL) transfers for EPL ruptures secondary to rheumatoid arthritis. METHODS: Twenty-four patients (7 males, 17 females; mean age 41 years; range 22 to 72 years) with rheumatoid arthritis underwent EIP to EPL transfer for 25 ruptures. The mean duration from rupture to surgery was 4.3 months (range 1.5 to 11 months). Functional assessment of the fingers was made using a specific EIP-EPL evaluation method developed by Lemmen et al. Pinch and grip strengths were measured. Range of motion of the metacarpophalangeal and interphalangeal joints of the thumb was compared with the normal side. Patient satisfaction was evaluated by a visual analog scale. The mean follow-up period was 6.2 years (range 4.7 to 7.9 years). RESULTS: Functional results were perfect in 14 fingers (56%), good in six fingers (24%), moderate in four fingers (16%), and poor in one finger (4%). The pinch and grip strengths were 86% and 92% of the uninvolved hand, respectively. The mean visual analog scale score was 74 (range 24 to 99). Compared to the uninvolved side, the range of motion of the thumb and index finger decreased by 23 degrees and 7 degrees , respectively, with a 9% loss of interphalangeal motion and a 17% loss of metacarpophalangeal motion in thumb extension. Independent extension of the index finger was possible in 21 hands. CONCLUSION: The results of EIP to EPL transfers are successful in ruptures secondary to rheumatoid arthritis.

[Giant cell tumor at the wrist: a review of 23 cases]. / El bileginde dev hücreli tümör: yirmi üç olgunun incelenmesi.

OBJECTIVES: We evaluated patients who underwent surgical treatment for giant cell tumor of the wrist with regard to recurrence rates, factors influencing tumor recurrence, complications, and postoperative functional and emotional status of the patients. METHODS: The study included 23 patients (6 males, 17 females; mean age 31.6 years; range 12 to 74 years) who were treated surgically for giant cell tumor of the wrist. Grading, assessment of surgical margins, and functional evaluation were performed according to the Enneking's criteria. The effects of tumor volume, soft tissue extension, and selected surgical therapy on recurrence were investigated. Joint movements and stability, postoperative pain, presence of deformity, muscle strength, limitations in functional activities, and patient satisfaction were evaluated. The mean follow-up period was 6.7 years. RESULTS: Of all the patients, 69% had stage 2 and 23% had stage 3 tumors. There was no significant correlation between tumor volume and recurrence (p=0.22). Recurrences were observed in three (33%) of nine patients with soft tissue extension and in four (28.6%) of 14 patients without soft tissue extension. Recurrence rates were 33.3% in those who were treated by curettage alone (n=3), 50% with curettage and grafting (n=6), 50% with curettage and bone cement (n=2), and 16% in those who underwent wide excision (n=12). CONCLUSION: The most important factor influencing recurrence rate in giant cell tumors is the extent of surgical resection. At least marginal resection must be considered in patients with stage 2 and 3 lesions especially in cases with soft tissue extension. Adjunctive therapy should be added if curettage is considered.

[Thumb duplication: an analysis of 72 thumbs]. / Cift basparmak anomalisi: 72 olgunun degerlendirilmesi.

OBJECTIVES: The aim of this study was to evaluate patients who were operated on for a duplicated thumb. METHODS: Sixty-seven patients (41 females, 26 males; mean age 2.5 years; range 6 months to 20 years) underwent surgery for a total of 72 duplicated thumbs between 1982 and 2003. Five patients had bilateral involvement. The anomaly was on the right in 39 cases, and on the left in 33 cases. Clinical and radiographic evaluations were made according to the Wassel classification. The Bilhaut-Cloquet technique was used in 13 symmetrically duplicated thumbs, while simple excision of the unserviceable part was performed in the remaining. Patient satisfaction was assessed with the use of a visual analog scale after a mean follow-up period of 3.6 years (range 1 to 10 years). RESULTS: Nail deformity was present in all cases treated by the Bilhaut-Cloquet technique. These thumbs did not exhibit growth retardation, but interphalangeal joint motion was limited in five, while seven had a larger size compared to the normal side. Limited range of motion was detected in eight cases (11.9%), affecting the metacarpophalangeal joint in one, and the interphalangeal joint in the others. Seventeen patients (25.4%) developed an angulation of more than 10 degrees in the alignment of the thumb. Secondary procedures were necessary in 25 cases (37.3%), including collateral ligament reconstruction (n=12; 17.9%), tendon rerouting (n=3; 4.5%), corrective osteotomy (n=5; 7.5%), and arthrodesis of the interphalangeal joint (n=5; 7.5%). Patient satisfaction with the surgical outcome was 85% (n=57). CONCLUSION: It is important to evaluate and treat the skin, nail, bone, and the ligaments in a simultaneous manner in order to obtain a good reconstruction and to decrease both the complications and the need for subsequent operations.

[Free radial forearm flap transfer for the reconstruction of the Achilles tendon and soft tissue defect: a case report]. / Asil tendon ve yumusak doku defektinin rekonstrüksiyonunda serbest radial önkol flep transferi: Olgu Sunumu.

Reconstruction of the soft tissue defects around the Achilles tendon is a difficult challenge. This condition traditionally has been treated with staged procedures. We report a case treated with a one stage procedure. A neuromusculocutaneous radial forearm free flap was used for the reconstruction of an achilles tendon and for covering the overlying large soft tissue defect caused by a gun shot injury. The defect on the Achilles tendon was 15 cm in length and soft tissue loss was 18 x 10 cm. The flap including flexor carpi radialis muscle tendon was applied over the Achilles tendon. A terminolateral arterial anostomosis was performed on the tibialis posterior artery. There was no complication except a mild superficial infection on the lateral side of the flap treated by antibiotherapy. A satisfactory functional result was obtained. Application of a free neuromusculocutaneous radial forearm composite flap is a good technique to cover achilles tendon and soft tissue defects and to restore the function as a one stage procedure.

[Giant-cell tumors of the tendon sheath involving the hand or the wrist: an analysis of 141 patients]. / El ve el bileginde tendon kilifinin dev hücreli tümörü: 141 hastanin degerlendirilmesi.

OBJECTIVES: Giant-cell tumors of the tendon sheath localized in the hand or wrist were retrospectively reviewed with respect to diagnosis, surgical treatment, and postoperative complications. METHODS: During a 21-year period, a total of 141 patients (83 females, 58 males; mean age 37.5 years; range 6 to 77 years) underwent surgery for 146 lesions that developed in the hand (n=134) or the wrist (n=12). Involvement was on the right side in 77 patients, and on the left side in 64 patients. The mean follow-up period was 3.5 years (range 6 months to 11 years). RESULTS: On presentation, the most common symptom was the presence of a painless soft tissue mass. The most frequent localization was the volar part (76%) of the second (27%) and the third (24) fingers, or the proximal phalanx (57%). Forty per cent of tumors were encountered at ages between 30 and 50 years. The duration of symptoms ranged from one month to five years and the highest number of presentations fell within the first six months. In eighteen patients, radiologic studies showed osseous involvement, being cortical sclerosis in 12 patients, and erosion in eight patients. Postoperative complications included digital nerve injuries in four patients, superficial infection in three patients, and joint stiffness in 12 patients. Twenty-three patients (16%) developed recurrences within a mean of 3.7 years (range 2 months to 7 years). CONCLUSION: Taking high rates of recurrences into consideration, surgery for giant-cell tumors of the tendon sheath requires wide surgical exposure, attentive skills, and the use of magnification.

[Long-term results of autograft and allograft applications in hand enchondromas]. / El yerlesimli enkondromlarin tedavisinde otogreft veya allogreft uygulamalarinin geç dönem sonuçlari.

OBJECTIVES: We evaluated the long-term results of treatment with curettage followed by an autograft or allograft application in patients with enchondroma of the hand. METHODS: Within a 15-year period, 76 patients (41 males, 35 females; mean age 32 years; range 14 to 47 years) were operated on for enchondroma of the hand. Following curettage of the lesion, reconstruction of the defect was made either by an autograft obtained from the iliac crest (n=76) or by a dehydrated cancellous allograft (n=15). The diagnosis was histologically confirmed in all the cases. Functional and radiographic results were assessed according to the Enneking scoring system and the Tordai classification system, respectively. The mean follow-up periods were 13.5 years (10-22 years) and 7.4 years (6-11 years) in autograft and allograft applications, respectively. RESULTS: Consolidation of the autografts took a mean of 38 days and maximum grasp force was obtained in a mean of 46 days. These periods were 51 and 55 days, respectively, for the allografts. Functional results were excellent/very good in 64%, good in 23%, and poor in 13.1% with autografts; radiographically, 78.7% of the patients were in group I, 18% were in group II, and 3.3% were in group III. Of the allograft group, the results were excellent/very good in 66.7%, good in 26.7%, and poor in 6.7%. Radiographically, 80%, 13.3%, and 6.7% of the patients were classified in group I, II, and III, respectively. There were two recurrences in the autograft group, while one patient, in the allograft group, who had multiple enchondromatosis required a ray amputation because of malignant transformation. CONCLUSION: Autograft and allograft applications seem to yield similar success rates in the treatment of enchondroma of the hand.

Solitary eosinophilic granuloma of the third metacarpal at pediatric age.

Langerhans cell histiocytosis involves disorders previously referred to as "histiocytosis X" (including eosinophilic granuloma of bone, Letterer-Siwe, and Hand-Schüller-Christian syndrome). Eosinophilic granuloma of the hand, especially if solitary, is extremely rare. This is the third pediatric case reported in the literature with solitary eosinophilic granuloma of the hand and the second with metacarpal involvement. The patient's lesion was curetted and the histologic examination showed eosinophilic granuloma. The patient received adjuvant radiotherapy because of continuing mild functional impairment and fracture risk. At 12-month follow-up near complete recovery of the lesion was observed. Radiologically, there was sclerosis and remodeling of the third metacarpal. The patient is disease-free at 26 months.

[An appropriate alternative for the reconstruction of soft tissue defects in the hand and the wrist: the distally-based island posterior interosseous flap]. / El ve el bileginin yumusak doku defektlerinin tedavisinde uygun bir alternatif: Ters akimli posterior interosseöz ada flebi.

OBJECTIVES: We evaluated the use of a distally-based island posterior interosseous flap in patients with soft tissue defects of the hand and the wrist. METHODS: The distally-based island posterior interosseous flap was used to cover soft tissue defects in eight patients (1 female, 7 males; mean age 30 years; range 9 to 51 years). Of these, six patients had crush injuries, and two patients had wrist flexion contracture due to high-voltage burns. The defects were in the volar aspect of the wrist in two patients, in the dorsum of the thumb metacarpal in two patients, and in the dorsum of the metacarpals in four patients. The mean follow-up period was 3 months (range 2 to 7 months). RESULTS: The results were satisfactory in all but one patient. Flap necrosis developed in one patient with crush injury of the hand and blunt injury of the forearm. Venous congestion of the flap was encountered in four patients, but none resulted in flap necrosis during the follow-up period. CONCLUSION: The distally-based island posterior interosseous flap may be easily and safely employed in the coverage of soft tissue defects of the hand and the wrist due to such advantages as minimal donor area morbidity, an acceptable cosmetic appearance, and a more simple dissection than required for other surgical flaps.

[Glomus tumors of the finger: a report on 60 cases]. / Parmak yerlesimli glomus tümörü: 60 olgunun incelenmesi.

OBJECTIVES: We evaluated patients who underwent surgery for glomus tumors of the finger. METHODS: During a 23-year period, 60 patients (48 females, 12 males; mean age 34.6 years; range 5 to 60 years) underwent surgery for glomus tumors of the finger. The patients were evaluated with respect to symptoms on presentation, diagnosis, operation types, and postoperative complications. The mean follow-up was 16 months (range 6 to 72 months). RESULTS: The most common symptom was pain (67%), which intensified when exposed to cold in 42%. Other symptoms included tenderness in 37 patients (62%), swelling in the finger tip in six patients (10%), and nail deformities in 34 patients (57%). The tumors were most frequently encountered in the fourth and fifth decades of age. Localization of the tumor was in the right hand in 32 patients (53.3%), and in the left hand in 28 patients (46.7%). The time to surgery from the onset of symptoms ranged from six months to 30 years (mean 6 years). Fifty-one patients were examined by plain radiographs, 27 of which showed concave-surface erosions in the bone; nine patients underwent magnetic resonance imaging studies besides plain radiography. The tumors were subungual in 49 patients (82%) and in the pulp in 11 patients (18%), for which transungual and midlateral approaches were applied, respectively. Postoperatively, nine patients (15%) developed recurrences, all of whom achieved clinical recovery following a subsequent operation. CONCLUSION: Given the considerably delayed time to diagnosis, glomus tumors should be taken into consideration in the presence of severe finger tip pain of unknown origin.