[Plantar fibromatosis: therapy by total plantarfasciectomy]

Morbus Ledderhose is a rare fibromatous disease of the plantar fascia. Clinical features include palpable solitary or multiple nodules and cords, mainly affecting the medial part of the plantar fascia. When clinical symptoms occur, conservative options include stretching, orthotics, nonsteroidal antirheumatic drugs, local cortisone-injections and physiotherapy. Operative treatment is indicated in case of persistent pain or if conservative measures fail. The standard procedure includes a partial fasciectomy of the plantar aponeurosis. There is a high recurrence rate with an increased risk of complications and more aggressive ingrowth into anatomical structures after partial resection. Therefore we recommend a complete fasciectomy not only in recurrent disease, but also as the primary procedure of choice.