Plantar fibromatosis is a benign proliferative neoplasia of the plantar fascia. Fibrous nodules may cause foot pain or swelling and sometimes an inability to straighten the toes. Orthoses can help redistribute pressure away from the fibrotic nodular lesions. Glucocorticoid injections directly into the nodule may sometimes be needed.
(See also Overview of Foot and Ankle Disorders.)
In plantar fibromatosis, fibrous nodules along the plantar fascia are displayed most easily when the foot is dorsiflexed against the leg. Most patients also have palmar nodules, usually located at the fourth metacarpophalangeal joint. Reported associations with diabetes, epilepsy, and alcohol use disorder may be anecdotal.
Fibrous nodules may cause foot pain or swelling and sometimes an inability to straighten the toes.
Treatment of Plantar Fibromatosis
If symptomatic, orthoses
Sometimes glucocorticoid injections
Treatment of plantar fibromatosis is usually not indicated unless the nodules become large enough to cause pressure-related pain with weight bearing. If so, orthoses can help redistribute pressure away from the fibrotic nodular lesions. Glucocorticoid injections directly into the nodule may be tried (see Considerations for Using Glucocorticoid Injections).
Surgery usually results in recurrence and sometimes painful scar tissue necessitating further surgery. Excessive fascial removal may also result in unintentional instability of the foot and the loss of arch height.
