The surgery of distal phalanx bone tumors requires a thorough knowledge of nail anatomy and must be performed in an operating room that meets orthopedic surgery standards. Strict adherence to aseptic operative techniques is required. When the overlying epidermis is intact no perioperative antibiotic prophylaxis is necessary. However, when there is a break in the skin an intravenous injection of an antibiotic that covers staphylococci, for example, a second-generation cepholosporin (cefuroxim, cefotiam), is injected 20 to 60 minutes before the start of surgery. Another option is azithromycine, 500 mg/day for three days starting the day prior to the surgery.