Abstract: Objective: To evaluate the clinical efficacy and aesthetic outcomes of an individualized surgical strategy for the resection of subungual glomus tumors, which involves partitioning and localizing the nail plate based on the location of the subungual tumor and selecting the direction of nail-flap elevation based on the partition localization. Methods: This study retrospectively analyzed 12 patients with subungual glomus tumors admitted to the Department of Hand Microsurgery and Foot Surgery, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from May 2022 to July 2024. Preoperative nail plate partitioning was performed based on the location of the lesion, and tumor resection was completed using a directional flap-style nail elevation technique. The visual analogue scale ( VAS ) was used to evaluate postoperative pain relief and tumor recurrence, while aesthetic outcomes were evaluated using a Nail Morphology Score and Patient-Reported Outcomes ( PROs ). Results: The postoperative follow-up time was 8 to 24 months, with an average of 16 months. The VAS score decreased significantly from the preoperative value to that at the last follow-up. The postoperative Nail Morphology Score was 8.5±0.9, and the patient satisfaction score was 9.2±0.7. No tumor recurrence or significant nail plate deformity was observed during the follow-up period. Conclusion: Individualized nail elevation and resection based on tumor location for subungual glomus tumors can achieve adequate exposure of the lesion while preserving the aesthetic appearance of the nail plate.

Key words: subungual glomus tumor, surgical procedures, aesthetic outcomes, nail plate partitioning, individualized nail-flap elevation