Plantar Fibromatosis Management and Treatment Approaches

Plantar fibromatosis, commonly referred to as Ledderhose disease, is a benign yet locally aggressive proliferation of fibroblasts and collagen within the plantar fascia. Clinically, it presents as firm nodules along the medial arch of the foot, often producing pain and functional impairment. Management strategies range from watchful waiting in asymptomatic cases to a spectrum of conservative and surgical interventions. Conservative measures include physiotherapy, orthotic support and pharmacological agents such as anti-inflammatories or intralesional steroids. Radiotherapy has emerged as a non-surgical option to inhibit fibroblast activity, while extracorporeal shock wave therapy (ESWT) offers a less invasive modality to alleviate pain and modulate tissue remodelling. When conservative and minimally invasive approaches fail, surgical excision—often by subtotal fasciectomy—remains the mainstay, although recurrence rates can be substantial. Optimal treatment selection requires individualised assessment of symptom severity, lesion size and patient comorbidities, with ongoing research focusing on refining protocols to balance efficacy, safety and long-term outcomes.

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Plantar Fibromatosis Management and Treatment Approaches publication trend

The graph below shows the total number of articles in plantar fibromatosis management and treatment approaches across all publications each year (not limited to Nature Index journals).

Technical terms

Fibroblast: A type of cell that synthesises collagen and extracellular matrix, central to nodule formation in fibromatosis.

Plantar fascia: The thick fibrous band supporting the arch of the foot and anchoring to the calcaneus and forefoot.

Extracorporeal shock wave therapy (ESWT): A non-invasive technique using focused acoustic waves to promote tissue regeneration and pain relief.

Radiotherapy: The use of ionising radiation to inhibit proliferative fibroblasts and reduce nodule progression.

Subtotal fasciectomy: A surgical procedure involving the excision of a portion of the plantar fascia to remove fibromatous tissue and alleviate symptoms.

References

1. Radiotherapy for Ledderhose disease: Results of the LedRad-study, a prospective multicentre randomised double-blind phase 3 trial. Radiotherapy and Oncology (2023).
2. Pain-Relieving Effects of Shockwave Therapy for Ledderhose Disease: An Ultrasound-Based Study of an Unusual Bilateral Case. Life (2024).
3. Ledderhose’s Disease: An Up-to-Date Review of a Rare Non-Malignant Disorder. Clinics and Practice (2023).