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Excision Plantar Lesion Technique

Lesions or tumors on the bottom of the foot are awkward and sometimes debilitating. No one knows what causes them--only that they are more common among men, children and the elderly. Most patients want to get rid of plantar fibramatosis quickly and with as little pain as possible. How can a doctor best serve a plantar fibromatosis patient?

  1. The Only Cure

    • According to Podiatrist Matt Sabo in his August 2007 article in "Podiatry Today," there is no effective medical treatment for plantar fibromatosis. The only effective treatment is a surgical excision.

      Even after proper removal of a lesion, plantar fibromatosis commonly regenerates quickly. However, while malignancy is rare in plantar lesions, malignancy among post-surgically regenerated lesions is even rarer. So, if nothing else, surgical excision reduces cancer risks. And, if all goes well, surgical excision can be a cure.

    Excision Technique

    • Radical plantar fasciotomy usually works best if the doctor or surgeon uses Z or S-shaped incisions. The idea is not only to cut out the fibroma tissue, but also to take at least 1.5 cm of healthy plantar tissue to create enough buffer to hopefully prevent the tumor from regenerating.

      The doctor or surgeon must be careful not to disrupt tissue in the medial fasial band. Since lesions are commonly found at the site of the medial fascial band, the doctor must also be careful of the medial plantar digital nerve and flexor hallucis brevis muscle. In cases of plantar aponeurosis fibromas, this can be especially difficult as they may intersect with meidal fasial band tissue.

    Success and Palliative Treatment

    • Excision is often successful and patients heal relatively easily. The site of the former lesion will require monitoring for several weeks or months to watch for lesion regeneration.

      However, before resorting to surgical procedures, most dermatologists and podiatrists recommend palliative measures such as padding, orthotic management, non-steroidal anti-inflammatory drugs (NSAIDs) and physical therapy. These measures may help a patient live successfully with a small lesion that is either slow growing or that has stopped growing.

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