Plantar Fibroma (Ledderhose disease)

What is a plantar fibroma?

It is a hard mass that grows in the plantar fascia and can range from 1 to multiple nodules. Plantar fibromas are benign, slow growing, and are symptomatic when they are large enough to cause pain from pressure of walking and standing. 

What are the causes of plantar fibromas?

The exact cause of developing plantar fibromas are unknown, but thought to be genetic. There are certain risk factors that increase the chance of developing them: trauma to plantar fascia, taking phenytoin (dilantin), epilepsy, alcoholism, liver cirrhosis, hypothyroidism, diabetes. 

How to diagnose plantar fibromas?

Typically it is a clinical diagnosis and biopsy is not recommended because it can cause plantar fibromas to grow. MRI can be used to confirm the diagnosis. 

How to treat plantar fibromas?

Since plantar fibromas are benign if they are not causing any pain they are left alone. When they start causing pain from pressure the first line of treatment is offloading using custom orthotics/pads, NSAIDS, and physical therapy. If pain continues then a steroid injection, transdermal verapamil cream (promote the activity of collagenase and inhibit collage production), collegenase injections, or radiation therapy can be considered. Tamoxifen has shown benefits in treating Dupuytren, but has not been studied in plantar fibromas.

Is surgery an option to treat plantar fibromas?

Surgery can be done, but is not recommended because patient’s can develop flattening of the arch and hammertoes afterwards.. A radical resection of the entire plantar fascia has to be done because if you only remove the plantar fibroma there is a high risk of developing more fibromas in the remaining fascia. 

If you have foot or ankle pain and would like a consultation. Make an appointment at Orange County Podiatry with Dr. Andrew Yang or call (949) 651-1202