Plantar Fibromatosis: Pathophysiology, Surgical and Nonsurgical Therapies: An Evidence-Based Review

Carroll, P; Henshaw, Robert M.; Garwood, Caitlin S.; Raspovic, Katherine M.; Kumar, Dhiren

doi:10.1177/1938640017751184

Cited by 35 publications

(65 citation statements)

References 36 publications

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“…PF is most often benign, but may cause pain and difficulty with ambulation and weight bearing as well as pain due to impingement of neurological or musculoskeletal structures as a result of the growing nodules [5]. The nodules are encapsulated, firm, and most commonly appear on the medial and central aspects of the plantar aponeurosis [6]. The formation of these fibromas is caused by the hyperproliferation of the fibrous tissue due to increased fibroblastic activity.…”

Section: Epidemiology and Pathophysiologymentioning

confidence: 99%

Closed-Incision Negative Pressure Therapy in Place of Surgical Drain Placement in Plantar Fibroma Excision Surgery: A Case Series

Karlock

Napolitano²

2020

Cureus

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Plantar fibromas are benign masses of fibrous tissue that develop in the arch of the foot arising from the plantar fascia. Symptomatology varies and is often related to weight bearing anatomic correlations or impingement of neurological or musculoskeletal structures. Several treatment options are available and include palliative measures, non-operative interventions and surgery, all with varying degrees of success and complication risk. The aim of this case study series was to assess surgical wound healing retrospectively in three patients who underwent wide en bloc plantar fibroma excision surgery for symptomatic lesions. Their incision was managed with a disposable closed-incision negative pressure therapy device (Prevena™; 3M + KCI, St. Paul, MN) in lieu of surgical drains. All three patients demonstrated favorable outcomes without complications.

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Section: Epidemiology and Pathophysiologymentioning

confidence: 99%

Closed-Incision Negative Pressure Therapy in Place of Surgical Drain Placement in Plantar Fibroma Excision Surgery: A Case Series

Karlock

Napolitano²

2020

Cureus

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“…The prevalence and etiology of PF is not currently understood 8,9. Though the number of people afflicted has not been precisely assessed, the disease continues to appear on the National Institute of Health’s list of rare diseases affecting <200,000 people 10.…”

Section: Epidemiologymentioning

confidence: 99%

“…Men are more often affected than women 12,13. Bilateral disease is present ~25% of the time 9. It often appears concomitantly with hyperproliferative fibromatosis of other appendages, such as Dupuytren’s disease in the hands, Peyronie’s disease in the penis, or keloid formation more generally.…”

Section: Epidemiologymentioning

confidence: 99%

“…It often appears concomitantly with hyperproliferative fibromatosis of other appendages, such as Dupuytren’s disease in the hands, Peyronie’s disease in the penis, or keloid formation more generally. Other associated conditions include frozen shoulder, alcohol addiction, diabetes, epilepsy, smoking, repeated trauma, and long-term phenobarbital use 9,14. One recent genome-wide association study has suggested a possible genetic predisposition to plantar fascial disorders, including PF 15…”

Section: Epidemiologymentioning

confidence: 99%

“…The objective of the treatment is to shrink the size of the nodules or fibromas, thus decreasing the associated pain experienced with ambulation. Steroid injections work by decreasing the expression of VCAM1 and altering the production of pro-inflammatory cytokines TGF-β and bFGF 9. These biochemical changes decrease inflammation, contracture rates, and growth rates, which result in smaller, less painful nodules.…”

Section: Non-operative Managementmentioning

confidence: 99%

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The etiology, evaluation, and management of plantar fibromatosis

Young¹,

Sternbach²,

Willinger³

et al. 2018

ORR

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Plantar fibromatosis (Ledderhose disease) is a rare, benign, hyperproliferative fibrous tissue disorder resulting in the formation of nodules along the plantar fascia. This condition can be locally aggressive, and often results in pain, functional disability, and decreased quality of life. Diagnosis is primarily clinical, but MRI and ultrasound are useful confirmatory adjuncts. Given the benign nature of this condition, treatment has historically involved symptomatic management. A multitude of conservative treatment strategies supported by varying levels of evidence have been described mostly in small-scale trials. These therapies include steroid injections, verapamil, radiation therapy, extracorporeal shock wave therapy, tamoxifen, and collagenase. When conservative measures fail, surgical removal of fibromas and adjacent plantar fascia is often done, although recurrence is common. This review aims to provide a broad overview of the clinical features of this disease as well as the current treatment strategies being employed in the management of this condition.

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