Plantar Fibromatosis

a slowly enlarging mass on the plantar medial aspect of the foot. Adherent to the plantar fascia, painful with weightbearing. Overlying skin is mobile., often non-painful.  Can be evaluated with MRI.

RX: load-relieving insert and shoe modification is treatment of choice(Sammarco Foot Ankle Int 21:563;2000).  An indolent lesion can invade the neurovascular structures, necessitating operative intervention. Non-operative treatment begins with the construction of a well molded, padded shoe and an orthosis.  Lee TH, Wapner KL, Hecht PJ: Plantar fibromatosis. JBJS 1993; 75-A:1080-1084

Surgery=resection of fibroma and entire plantar fascia (60% recurrence with local excision only)