The Surgical Treatment of Plantar Fibromatosis With Multiple Large Nodules on the Medial Aspect of the Left Sole With No Recurrence at the Five-Year Follow-Up

左足内侧多发大结节足底纤维瘤病的手术治疗,五年随访未见复发

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Abstract

Plantar fibromatosis, or Ledderhose disease, is a rare benign fibroproliferative disorder of the plantar fascia characterized by the development of fibrous nodules, which may cause pain and functional limitation. Although the exact etiology remains unclear, it has been associated with trauma, diabetes mellitus, liver disease, epilepsy, and chronic alcohol use. Management is often conservative, but surgical intervention may be required when symptoms persist. A 32-year-old female presented with a six-month history of painful nodules on the medial aspect of her left sole. Clinical examination and ultrasonography revealed three hypoechoic nodules within the plantar fascia. Initial conservative treatment with nonsteroidal anti-inflammatory drugs (NSAIDs), stretching, orthotic insoles, and physiotherapy failed to improve symptoms. Surgical excision with partial plantar fasciectomy was therefore performed. Histopathological examination confirmed the diagnosis of plantar fibromatosis, showing dense fibrocellular tissue with fibrocytic and collagenous proliferation and myofibroblastic differentiation. The postoperative recovery was uneventful, and at five-year follow-up, the patient remained pain-free with no evidence of recurrence. Plantar fibromatosis should be considered in patients presenting with firm nodules on the plantar aspect of the foot. When conservative therapy fails, partial plantar fasciectomy can provide excellent functional outcomes and long-term symptom relief with a low risk of recurrence.

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