The Analysis Of Clinical Diagnosis And Treatment Of Finger Glomus Tumor

Objectives Glomus tumor of the finger is a rare tumor of soft tissue of hand,Which clinical misdiagnosis rate is high,and patients usually show unbearable pain,Clinician should be combined with physical examination and imaging examination diagnosis to diagnosis.Surgical resection can relieve the clinical symptoms of patients obviously,but some patients will have tumor recurrent and nail deformity after operation,which will giving patients physical and psychological pain again.The purpose of this study is to summarize the data of glomus tumor of the finger and to discuss its clinical characteristics,diagnostic methods,surgical treatment methods and treatment status.Explore the best surgical treatment of glomus tumor of the finger and the pathogenesis of postoperative complications,in order to improve the level of clinical diagnosis and treatment.Methods The clinical data from 17 cases of finger glomus tumor who were treated in the First Affiliated Hospital of Medical University Of Anhui rom March 2012 to May2017,which included the patient's age,gender,specific lesion,clinical features,imaging data,diagnostic methods,surgical methods and treatment status.The VAS score(mean visual analogue scale)were recorded preoperatively and 2 weeks,1 month,3 months and 6 months after operation respectively.To record the changes of the pain degree before and after the operation and the situation of the tumor recurrence and nail deformity within 6 months after operation.Reviewing the relevant literature and summarying clinical diagnosis and surgical treatment methods and the efficacy.The data were analyzed by SPSS 16.0 software,The measurement data were expressed as mean ± standard deviation,T test or analysis of variance was used for statistical inference of measurement data,Categorical variable data were described by rate or constituent ratio.P<0.05 thought the difference statistically significant.Results(1)In this group of cases,14 cases(82.4%)were females and 3 cases(17.6%)were males,the ratio of female to male is about 4.7: 1.The average age was 39.82 ±15.36 years(range,9-66 years)and the average course of disease was 5.65 ± 4.86years(range,1-19years).The size of the tumor was from 2 to 15 millimeter,with an average of 4.94 ± 2.90 millimeter.There were 12 cases(70.6%)appeared under the fingernail,2 cases(11.8%)appeared in the pulp and 3 cases(17.6%)appeared around the nail.The right hand incidence of 6(35.3%),left onset in 11 cases(64.7%),including 4 thumbs,4 index fingers,6 middle fingers,3 ring fingers.In our research,17 cases(100%)had positive Love's pin test,16 cases(94.1%)had positive cold sensitive test,and 14 cases(82.4%)had positive Hildreth test.The positive rates of X-ray,ultrasound and MRI were 22.2%,66.7% and 80% respectively.12 cases(70.6%)underwent Transungual surgery,3 cases(17.6%)patients underwent Lateral Subperiosteal procedure,and 2 cases(11.8%)patients underwent abdominal longitudinal incision.(2)The average preoperative VAS score of this group was 7.82 ± 1.74(4-10).The VAS scores at 2 weeks,1 month,3 months and 6 months after operation were 1.00 ±1.32(0-3),0.59 ± 1.12(0-3),0.53 ± 0.94(0-3),0.35 ± 0.70(0-2)respectively.The difference of VAS score between preoperative and postoperative time points had significant statistical significance(p<0.05).(3)There was 1 case recurrence of the tumor in this group of patients within 6months after surgery,the recurrence rate was 5.9%.Nail deformity 3 cases,of which 2cases had deformity before operation and were still present after operation,1 case of nail had mild indentation,and the rest of the cases recovered normal growth.The movement and the function of the fingers was normal in all cases.The quality of life of the patients was improved obviously.Conclusions:1.Diagnosis of finger glomus tumor should be comprehensive assessment of the clinical characteristics,diagnostic methods and imaging examination.2.Surgical treatment of finger glomus tumor can relief the subjective pain symptoms obviously.3.VAS score can help evaluate the changes of the patient's finger pain and determine the effect of the operation.4.With the aid of microsurgery,postoperative complications can be reduced significantly.5.Surgical treatment has certain recurrence rate and deformity rate,reduce the recurrence rate and deformity rate is the focus question when we treat the glomus tumor of the finger.