PLANTAR FIBROMATOSIS - A REVIEW OF PRIMARY AND RECURRENT SURGICAL-TREATMENT

Plantar fibromatosis can be quite disabling to the patient, as well as a technical challenge to the surgeon. Patients who undergo previous l ocal excisions and in whom aggressive recurrences develop are difficul t to manage successfully. We present a consecutive series of five prim ary procedures on patients with painful plantar fibroma and seven revi sion operations on patients with recurrent plantar fibroma. The averag e follow-up was 47 months (range, 22-66 months) in the primary group a nd 40 months (range, 21-78 months) in the revision group. The overall results were satisfactory in four of the five primary operations, with only one recurrence. In the revision group, five of seven results wer e satisfactory with no recurrences. The major complication that led to unsatisfactory results was the development of a postoperative neuroma . In this article, we outline our present surgical techniques of wide primary excision and a staged revision procedure with delayed split-th ickness skin graft closure. These techniques can be used successfully to manage this disabling, progressive disease.