A Case Report of Bilateral Plantar Fibromatosis and Review of Treatment Options

Abstract

Ledderhose disease is a rare benign pathology defined by the formation of nodules along the plantar fascia. The fibromas can slowly grow, resulting in pain and functional disability. Diagnosis is mainly clinical, but it is advised to confirm with an MRI or ultrasound scan. Multiple options of conservative treatment have been suggested with varying levels of evidence. Initially, the treatment aims to relieve symptoms and pain. Treatment options such as extracorporeal shockwave therapy, radiotherapy, intralesional steroid injection, Clostridium histolyticum collagenase injections, Verapamil and Tamoxifen can be used if the symptoms persist. A partial or complete fasciectomy is often performed in cases where conservative treatment fails. We present a case of bilateral plantar fibromatosis treated with extracorporeal shockwave therapy and transfer electrical capacitive and resistive therapy. The patient had an intense pain during the shockwave therapy sessions, which significantly decreased after the transfer electrical capacitive and resistive therapy protocol. At the 12-month follow-up, the patient showed significant improvement in the Visual Analog Scale from 6/10 to 1/10 on the right foot and from 8/10 to 4/10 on the left foot.