Plantar fibromatosis is a rare slow-growing lesion on plantar aponeurosis. It can be described as a benign disorder in which fibrous nodules may develop in the plantar aponeurosis, more specifically on the medial plantar side of the foot arch and on the forefoot area. In 25% cases it may be bilateral and rarely it may infiltrate to underlying skin or the planter muscle deep to it.
It is an autosomal dominant inherited condition with variable incidence among family members. The causative gene may remain dormant for generations and may surface at some time in an individual or multiple individual of same generations. There are some associate risk factors, like; family history, male gender, palmer fibromatosis, diabetes mellitus, epilepsy
Initially one feels a non-tender bulge like appearance on bottom of foot along medial border, inability to bend the foot properly, pain after prolonged walking or standing, deformity of toes and foot arch in very advance disease. Whether the swelling is big enough or not and causing any problem one should visit doctor to examine and differentiate other possibilities of swelling. MRI or Ultrasound is required to confirm the diagnosis
In early stage when the swelling is small accommodative and offloading insole is helpful to prevent any friction and pressure on the swelling. This helps is preventing any pressure discomfort and may help in delay the progression. Surgical excision is recommended only in significant large swelling and swelling restricting activity. Surgical excision is difficult because of its aggressive infiltrative nature which may infiltrate surrounding skin, tendon and nerves. Recurrence rate is very high after excision.