Plantar Fibromatosis


Plantar Fibromatosis, Plantar Fibroma

  • Definitions
  1. Plantar Fibromatosis (Plantar Fibroma)
    1. Fibrous proliferation of the plantar fascia and plantar aponeurosis
    2. Similar to Dupuytren's Contracture of palm
  • Risk Factors
  1. Dupuytren Contracture
  2. Peyronie Disease
  • Symptoms
  1. Slow enlargement of a painless Subcutaneous Nodule
  2. Eventually becomes tender and painful with walking or prolonged standing
  • Signs
  1. Palpable Nodule or thickening of the plantar fascia
  2. Involves medial half of middle of plantar fascia
  3. Contractures rarely occur
  4. Bilateral involvement in 20 to 50% of cases
  • Differential Diagnosis
  • Imaging
  1. Ultrasound
    1. Hypoechoic to isoechoic fusiform Nodules
  2. MRI
    1. Well defined mass with similar intensity to Muscle on T1 imaging
    2. Broad base at the superficial fascia
  • Management
  1. Molded Orthotic
    1. Allows transfer of weight away from Nodule
  2. Intralesional Corticosteroid Injection
  3. Surgery: Subtotal fasciectomy with wide excision
    1. Indicated when weight bearing becomes painful
    2. Often recurs after excision