Today I’m going to talk about a condition called a plantar fibroma. Essentially, this is one of the most common, benign masses that one can find inside the foot itself. There is a tissue on the bottom of the foot called the plantar fascia which is sort of a broad, strap-like tissue that runs from the heel to the ball of the foot. This tissue is sort of hard, rubbery type of fibrous tissue. What can often form on this tissue is a thickening of this fascia and formation of something called a fibroma or a plantar fibromatosis.
This essentially is a mass or a lump that forms within this tissue that one can feel when they run their fingers along the arch or the bottom of the foot, and in certain cases can also be felt while you’re walking. This lump can start off fairly small and there could be numerous of them, but they can also grow quite large and in doing so, can become quite painful, because you’re walking on a mass or a lump. Even the mass or lump itself can push into nerve tissue or sensitive type of tissue that is adjacent to where this mass sits. As I said, this condition is generally benign, but because of the nature of the pain that’s associated with it, it is often removed surgically to relieve the pain.
How do you treat a plantar fibroma?
There are non-surgical techniques that can help including padding and arch supports which can help to decrease strain and inflammation to the plantar fascia itself, and it can help to pad off this mass of tissue on the bottom of the foot. When this doesn’t work, then surgery is needed to remove the mass. Little, small masses that aren’t too long it’s fairly easy to get rid of. An incision is made around the arch itself and the mass is removed without incident. Usually it’s some borders surrounding one side and the other of the mass are also removed of the plantar fascia to ensure that the fibroma doesn’t reoccur again.
There is a chance that the mass itself can regrow at some point in time. However, when things get complicated during procedures in which there is a large mass or a large lump, certain things have to be done in order to keep the foot stable following the surgery. When you have a really long mass or a really large mass that needs to be removed, often a lot of the plantar fascia will have to removed in order to get rid of the mass as well as some margins on either side of it. Unfortunately, this can leave the foot somewhat unstable as the plantar fascia itself is a fairly important tissue that has a lot to do with the stability of the arch.
Once this tissue is removed, there are newer techniques available that can help to bridge the gap of removed tissue. There are certain grafts that are being utilized that can basically take the place of the plantar fascia and are essentially sewn in to where the plantar fascia, where that fibroma was removed in order to restore its length. Eventually, the body will incorporate this graft and essentially turn it back into plantar fascia tissue itself, essentially taking care of the gap that was created by removing the mass itself.
Unfortunately as I said, this condition can recur following surgery and other complications can occur including scarring of the tissue underneath the skin and the arch or even scarring of the skin itself. Generally for the majority of these types of cases, removal is fairly easy to do and fairly successful in relieving pain.