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Management of plantar fibromatosis

Discussion in 'General Issues and Discussion Forum' started by evew, Dec 19, 2011.

  1. evew

    evew Member


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    Hi All,

    I am looking for some advice for a patient that presented to me for assessment a few weeks ago.
    He is a 39 year old male who is very active - predominantly running and triathalons.
    Was running and noticed a sharp pain in the sole of his right foot 'felt like i had been shot'.
    He visited a physio who treated him for plantar fasciitis - stretching, massage, post night splints etc to no avail.
    He was worried that he had ruptured his plantar fascia - i referred him for an ultrasound which showed he has a 32x6x9mm (AP x SI x ML) plantar fibromatosis commencing 10mm distal to the calcaneal region. The radiologist recommended cortisone injection which he had last week.
    I am seeing him again this week - he is keen to proceed with orthotics (as rec by his physio) however I am concerned that they may further irritate the area. Biomechanically he functions quite well - lunge test, sup resistance test, jacks test, STJ axis all within normal limits.
    I would greatly welcome any feedback!
    Kind Regards
    Eve:santa2:
     
  2. Admin2

    Admin2 Administrator Staff Member

  3. efuller

    efuller MVP

    Is it visible or palpable?
     
  4. JAYNES

    JAYNES Active Member

    Hi Eve i use orthotics for this problem all the time they do give relief.

    Hope this helps
    Jayne
     
  5. evew

    evew Member

    Hi Efuller,

    No it is not visible or palpable. I did try some padding and strapping which did not alleviate any of his symptoms but rather irritated the area...

    eve
     
  6. evew

    evew Member

    Hi Jaynes

    thanks for replying.

    any preference for orthotic material, modifications?

    eve
     
  7. efuller

    efuller MVP

    Then an orthotic designed to reduce tension in the plantar fascia should work just fine. When the patient is in the chair, dorsiflex the hallux and if the plantar fascia is prominent a plantar fascial groove should be put into the orthosis.


    Eric
     
  8. evew

    evew Member

    Thank you and Merry Christmas

    Eve
     
  9. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    High-energy focussed extracorporeal shockwave therapy reduces pain in plantar fibromatosis (Ledderhose's disease).
    Knobloch K, Vogt PM.
    BMC Res Notes. 2012 Oct 2;5:542.
     
  10. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Patient-reported outcomes after electron radiation treatment for early-stage palmar and plantar fibromatosis.
    Schuster J et al
    Pract Radiat Oncol. 2015 Jul 2. pii: S1879-8500(15)00227-1
     
  11. Louelle

    Louelle Member

    I've had excellent results using ESWT for plantar fibromatoma (albeit very small sample but still - very promising)
     
  12. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Dupuytren-Like Contracture of the Foot: Ledderhose Disease
    Osman Akdag et al
    Surg J 2016; 02(03): e102-e104
     
  13. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Plantar fibromatosis: Surgical approach of a giant bilateral case
    Jorge Ocampo-Garza et al
    International Journal of Dermatology 19 December 2017
     
  14. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Ultrasonography of Plantar Fibromatosis: Updated Case Series, Review of the Literature, and a Novel Descriptive Appearance Termed the "Comb Sign".
    Cohen BE et l
    Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine [30 Mar 2018]
     
  15. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    Current concepts about treatment options of plantar fibromatosis: A systematic review of the literature
    Mario Fuiano et al
    Foot and Ankle Surgery; 11 June 2018
     
  16. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    Ledderhose’s Disease-What do We Know
    and What do We not know

    Ingo Schmidt et al
    SM Musculoskelet Disord. 2019; 4(1): 1033.
     
  17. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Palmar Fibromatosis: an Analysis of 25 Cases
    Source
     
  18. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    The Effects of Collagenase Clostridium histolyticum on Plantar Fibromatosis: A Case Study
    Jeffrey D.Lehrman et al
    The Journal of Foot and Ankle Surgery
    Volume 58, Issue 6, November 2019, Pages 1281-1284

     
  19. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Follow-up of clinical and sonographic features after extracorporeal shock wave therapy in painful plantar fibromatosis
    Jin Tae Hwang et al
    PLoS One. 2020 Aug 10;15(8)
     
    Last edited: Oct 16, 2020
  20. docbourke

    docbourke Active Member

    Plantar fibromatosis is a benign, self limiting condition. In the early stages it can be tender but after a few months it becomes pain free. Orthotics can be useful if there is a painful, tender lump to unload the spot itself. Once thhe pain and tenderness have gone the orthotics are not needed. If the fibroma is operated on or even innjeeted there is a significant risk that it will recur in a more aggressive form and in larger numbers so injection and surgery are contra indicated. Plantar fibromata are common incidental findings and if it is not palpable then it is most likely not the cause of the symptoms unless it is the early stages and it is still growing.
     
  21. Ed Davis DPM

    Ed Davis DPM Welcome New Poster

    Plantar fibromatosis or Ledderhose Disease is occasionally self limiting but there are many cases that are disabling. Surgical treatment has an unacceptably high recurrence rate. I have been using, off label, hyaluronidase injections, with good results for a number of years. Unfortunately, the system here does not allow me to post links to additional information.
     
  22. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Recurrence Rate After Wide Resection of Plantar Fibromatosis: A Case Series and Systematic Literature Review
    Helen Anwander et al
    Foot Ankle Spec. 2021 Aug 8
     
  23. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
  24. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    A Case Report of
    Bilateral Plantar Fibromatosis
    and Review of Treatment Options

    Dimitrios ZACHARIOU et al
    MAEDICA – a Journal of Clinical Medicine
     
  25. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    "Modifiable Risk Factors for Prevention in Dupuytren's Disease: A UK Biobank Case-Control Study."
    Youngjoo Kang et al
    Plast Reconstr Surg. 2023 May 31.
     
  26. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Flexion Contracture and Valgus Deformity of the Great Toe are Symptoms
    of Plantar Fibromatosis

    Hiroshi Kishimaru
    Clin Res Foot Ankle 2023, 11:9
     
  27. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Ultrasound-Guided Collagenase Injection Therapy of Recurrent Plantar Fibromatosis: A Case Report
    Antje L. Greenfield et al
    Source
     
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