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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.
     
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    NewsBot The Admin that posts the news.

    Articles:
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    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)
     
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    Dupuytren-Like Contracture of the Foot: Ledderhose Disease
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    Surg J 2016; 02(03): e102-e104
     
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    Articles:
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    Plantar fibromatosis: Surgical approach of a giant bilateral case
    Jorge Ocampo-Garza et al
    International Journal of Dermatology 19 December 2017
     
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    Articles:
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    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]
     
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