Recurrence of Plantar Fibromatosis after Plantar Fasciectomy

NewsBot · Jul 16, 2008

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Recurrence of Plantar Fibromatosis after Plantar Fasciectomy: Single-Center Long-Term Results.
van der Veer WM, Hamburg SM, de Gast A, Niessen FB.
Plast Reconstr Surg. 2008 Aug;122(2):486-491

BACKGROUND:: Plantar fibromatosis is a rare, hyperproliferative, benign lesion of the plantar aponeurosis with an unknown cause. Surgical treatment is associated with a high recurrence rate and risk of complications. The goal of this study was to determine the recurrence rate of plantar fibromatosis after plantar fasciectomy at the authors' institute during the past three decades and the factors associated with an increased risk for recurrence.

METHODS:: The study group contained 27 patients with plantar fibromatosis, who underwent 40 operations on 33 feet, including 13 right (39 percent) and 20 left (61 percent) feet.

RESULTS:: The overall recurrence rate was 60 percent. Treating a primary lesion with total plantar fasciectomy was associated with the lowest (25 percent) and local resection of the lesion was associated with the highest recurrence rate (100 percent). There seemed to be a relation between the existence of multiple nodules in one foot and a higher recurrence rate. The recurrence of a primary lesion treated with fasciectomy combined with postoperative radiotherapy seemed to be lower in comparison with the recurrence rate after surgery only.

CONCLUSIONS:: Surgical treatment of plantar fibromatosis is associated with a high recurrence rate and indicated only when the lesions are highly symptomatic and conservative measures fail. Total plantar fasciectomy is the most successful treatment in this study, particularly for primary lesions. The role of postoperative radiotherapy should be evaluated further. A prospective multicenter study comparing different surgical procedures will be needed to determine the type of operation that most effectively eliminates plantar fibromatosis.
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Bruce Williams · Jul 16, 2008

NewsBot said: ↑

Recurrence of Plantar Fibromatosis after Plantar Fasciectomy: Single-Center Long-Term Results.
van der Veer WM, Hamburg SM, de Gast A, Niessen FB.
Plast Reconstr Surg. 2008 Aug;122(2):486-491
Click to expand...

In my opinion a plantar fibromatosis is not a real soft tissue lesion, but instead a reaction to a ruptured or traumatized portion of the fascia.

I would agree with the authors conclusion that only total fascial removal will prevent return of the majority of these lesions. I don't know that I would ever suggest this procedure, let alone perform it, but I do understand the conclusion.

This shows our collective lack of understanding of fascial structures and how they respond to stresses, surgical and non-surgical.

Bruce

NewsBot · Feb 21, 2017

Partial fasciectomy is a useful treatment option for symptomatic plantar fibromatosis
Haji Khairul Abd Kadir, Coonoor R. Chandrasekar
The Foot; 21 February 2017

Highlights
•Plantar fibromatosis is a rare, benign fibroproliferative disorder of the plantar fascia but it can be locally aggressive.
•Surgical excision is the mainstay of treatment but recurrence rate is known to be high.
•We present a series of 18 patients treated with partial plantar fasciectomy with low recurrence rate.
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Plantar fibromatosis is a rare, benign fibroproliferative disorder of the plantar fascia. It is considered as a low-grade tumour and it can be locally aggressive. It can present as painful swelling with impairment of local function. Upon failure of non-operative management, surgical treatment options include total fasciectomy or partial fasciectomy. Although surgical excision is the mainstay of treatment, recurrence rate can be up to 60%. The aim of this study was to determine the recurrence and complication rates of surgically treated plantar fibromatosis.

We performed a retrospective study involving patients who had a confirmed diagnosis and excision of plantar fibromatosis treated in our institution between 2011 and 2016. Demographic data, follow-up duration, recurrence and complications were reviewed.

Eighteen patients underwent 19 operations. Mean age was 41.3 years (20-57). There were 12 male patients. The main presenting features were pain, swelling and impairment of function. They were investigated by ultrasound scan (12 feet, 63%) and/or magnetic resonance imaging (8 feet, 42%). Two patients (11%) had prior surgery at other institutions whilst 3 patients (17%) had multiple nodules at presentation. All patients underwent partial fasciectomy of the plantar fibromatosis. At up to 5 years follow-up, one patient (6%) had a recurrence in our series whilst 3 patients (17%) had scar related problems (2 patients with scar pain and one patient had hypersensitive scar that resolved after 12 months).

Symptomatic plantar fibromatosis can be effectively treated with partial plantar fasciectomy.
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Bruce Williams Well-Known Member

NewsBot The Admin that posts the news.

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