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Plantar Fibromatosis
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Plantar fibromatosis is a condition that presents with firm bumps, or nodules, that are found in the plantar fascia. Plantar fibromatosis can be quite disabling to the patient, as well as a technical challenge to the surgeon. Patients who undergo previous local excisions and in whom aggressive recurrences develop are difficult to manage successfully. When examined under a microscope, plantar fibromatosis represents a proliferation of scar tissue; almost an overgrowth of scar tissue with in the fascia. Although the origin of plantar fibromatosis is unknown, some authors have speculated that it is a aggressive healing response to small tears in the plantar fascia. It's almost as if the fascia over repairs itself following an injury. Other authors have postulated that plantar fibromatosis is due to a congenital deformity (present at birth) or due to a history of puncture injuries to the foot. Initial treatment of plantar fibromatosis is to avoid direct pressure to the nodules. In many cases, the only pain found with this condition is when the nodule rubs on the shoe or floor. Soft inner soles and padding may be helpful to pad and cushion the nodules. When plantar fibromatosis becomes painful, most doctors recommend surgical excision of the lesions. In most cases, the surgery is performed on an out-patient basis using sedation and a local anesthetic. Most cases of plantar fibromatosis require an incision on the bottom of the foot. With a plantar incision, most doctors will require the patient to be non-weight bearing for a 3 week period of time. As a result, the surgery is not all that difficult to get through, but the recovery, and being on crutches for 3 weeks is a challenge. |
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