Recurrence of plantar fibromatosis after plantar fasciectomy: single-center long-term results.
BACKGROUND
Plantar fibromatosis is a rare, hyperproliferative, benign lesion of the plantar aponeurosis with an unknown cause. Surgical treatment is associated with a high recurrence rate and risk of complications. The goal of this study was to determine the recurrence rate of plantar fibromatosis after plantar fasciectomy at the authors' institute during the past three decades and the factors associated with an increased risk for recurrence.


METHODS
The study group contained 27 patients with plantar fibromatosis, who underwent 40 operations on 33 feet, including 13 right (39 percent) and 20 left (61 percent) feet.


RESULTS
The overall recurrence rate was 60 percent. Treating a primary lesion with total plantar fasciectomy was associated with the lowest (25 percent) and local resection of the lesion was associated with the highest recurrence rate (100 percent). There seemed to be a relation between the existence of multiple nodules in one foot and a higher recurrence rate. The recurrence of a primary lesion treated with fasciectomy combined with postoperative radiotherapy seemed to be lower in comparison with the recurrence rate after surgery only.


CONCLUSIONS
Surgical treatment of plantar fibromatosis is associated with a high recurrence rate and indicated only when the lesions are highly symptomatic and conservative measures fail. Total plantar fasciectomy is the most successful treatment in this study, particularly for primary lesions. The role of postoperative radiotherapy should be evaluated further. A prospective multicenter study comparing different surgical procedures will be needed to determine the type of operation that most effectively eliminates plantar fibromatosis.
van der Veer
Willem M
WM
Amsterdam, The Netherlands From the Department of Plastic and Reconstructive Surgery and the Department of Orthopaedic Surgery, VU University Medical Center.
Hamburg
Stijn M
SM
de Gast
Arthur
A
Niessen
Frank B
FB
D000293:Adolescent; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005205:Fascia / Q000473:pathology; D000071938:Fasciotomy; D005260:Female; D005350:Fibroma / Q000235:genetics / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D005534:Foot Diseases / Q000235:genetics / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications / Q000601:surgery*; D018714:Radiotherapy, Adjuvant; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013524:Surgical Flaps; D016474:Weight-Bearing / Q000502:physiology; D055815:Young Adult