Description, Causes and Risk Factors:
Nodular fibroblastic proliferation in plantar fascia of one or both feet; rarely associated with contracture.
Plantar fibromatosis is a rare condition in which benign (non-cancerous) tumors called plantar fibromas grow on the bottom (plantar surface) of the foot. The plantar fascia is a long band of connective tissue that runs from the heel to the toes on the bottom of the foot. Plantar fibromas are firm masses that grow slowly along the plantar fascia, and they contain excess collagen or fibrotic tissue. They can be present in one or both feet.
In the early stages of this condition, the fibromas are small and do not interfere with the function of the foot. As the fibromas continue to grow, bending the toes becomes more difficult and walking becomes painful.
Although the cause of plantar fibromatotis is still not known, trauma is thought to have a role in the development of this condition. A puncture wound or micro-tear can cause formation of fibromas. Some medications have been linked to fibrotic tissue disorders. These include anti-seizure medications, beta-blockers supplements, and large doses of supplemental vitamin C can promote the production of excess collagen and fibrotic disorders.
Plantar fibromatosis is more common in Caucasians than in any other race, and more common in males than females. Plantar fibromatosis are more common in middle-aged and elderly people, especially men over seventy. There is another condition called superficial plantar fibromatosis that is more common in children than adults. Juvenile aponeurotic fibroma (JAF) and aggressive infantile fibromatosis (AIF) are also a part of the fibromatosis group. These conditions may be present at birth.
Symptoms consist of a painful mass on the bottom of the foot, roughly in the middle of the arch or instep, between the heel pad and the forefoot pad. The mass will cause a soft convexity in the contour of the bottom of the foot that may be painful with pressure or shoewear.
Although x-rays are usually required prior to advanced imaging studies, they are not sufficient to diagnose fibromas. Podiatrists use MRIs to visualize plantar fibromatosis. An MRI will assist him/her in determining the shape, size, and depth of the fibroma. Many reach the aponeuroses (the flat, fibrous sheet of connective tissue that attaches muscle to bone). He also will need to know about your medical history, medications, Lifestyle, supplements, symptoms, and family medical history.
Treatment will depend upon the size and location of the fibromas, and whether or not they are causing pain. When plantar fibromas are small and cause minimal pain, treatment usually consists of alleviating direct pressure to the fibroma. This is accomplished through padding, functional foot orthotics, night splints, heel lifts, or arch supports. Pressure reduction has been shown to shrink the fibromas. Verapamil 15% gel (a calcium channel blocker used to treat angina, irregular heartbeat, and high blood pressure) has been shown to shrink plantar fibromas. The verapamil gel is applied to the mass twice daily.
There are also two invasive treatment options available: cortisone injections and surgery. Cortisone injections may be helpful, but can cause the fibroma to enlarge and possibly multiply. If the mass is painful and conservative methods have failed, the fibroma may be surgically removed. Unfortunately, even if it is surgically removed the fibroma may grow back. Complications from surgical removal may include hammertoes and flat feet. The decision to intervene surgically is made on a case-by-case basis. The procedure is performed at the Hospital in the Operating room/Surgical center. You will need someone to drive you home after the procedure due to the effects of the anesthesia. You will need to use crutches or a walker for three to four weeks following the procedure.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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