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