Subungual Exostosis

A subungual exostosis is a bony spur that grows off the tip of the bone lying underneath the toenail (sub- meaning below and -ungual meaning nail). This bony prominence arises in response to chronic irritation or injury, like dropping an object on the toe, and can be seen on x-ray. The overlying toenail is often thickened and malformed. The sides of the nail may curve inward and pinch the adjacent skin causing an ingrown toenail.

If wearing shoes with a heightened toe box does not relieve pain, surgery is indicated. Your doctor will decide if the toenail must be removed. A small incision is made at the tip of the toe and the bony spur is filed down. Your doctor may choose to do the procedure in the office or in a surgical center. Following surgery, you will have a couple of sutures that will be removed within 10 to 14 days. Pain medication will be prescribed as needed, but pain is usually minimal.