Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

Plantar Fibroma

Posted by Dave R on 9/23/02 at 21:23 (096051)

About 6 months ago I began having some soreness in my inner arch/heel. After 2 months the soreness remained so I went to a podiatrist. He sent me to therapy and made orthotics for me. After wearing the orthotics the soreness in my arch was slightly worse.
So they performed an ultra-sound and found a large plantar fibroma. He recommended surgery to remove the plantar facia. He said that the plantar facia is not needed...it has little or no function...basically 'the appendix' of the foot.
I'm concerned about the long term recovery to normal. ( I know that the initial surgery recovery is about 3 months ) Other than the scar....will my foot function just as well as it did before the fibroma? What is the result of removing the plantar facia? Can I lose normal foot function beyond the initial surgery healing time?

Re: Plantar Fibroma

Dr. Z on 9/23/02 at 22:04 (096057)

Thre is a fairly high re-occurrence when excising a plantar fibroma. Injection therapy with orthosis is very effective. Surgery varies and some literature related a very high re-occurrence. The funcction of the plantar fascia is very important and removal can and does cause biomechanical dysfunction and possible pain in other areas of the foot. Becareful and beward and get another opinion.

Re: Plantar Fibroma

Julie on 9/23/02 at 23:30 (096065)

Dave

I'm not a doctor, but I can't imagine how a podiatrist could tell you that the plantar fascia serves no function. Even if we'd never heard of the fascia, and knew nothing about it, we'd be able to see from looking at a picture of the structure of the foot that it connects the bones at the ball of the foot with the heelbone and therefore must be supporting the arch.

Please get another opinion.

Re: Plantar Fibroma

Dave R on 9/24/02 at 20:36 (096140)

Thanks for the advice. I did get a second opinion today. The advice was that I do indeed have a plantar fibroma located close to the heel end of the plantar facia. Also he said that he strongly advises removal but suggests an MRI in addition to the ultra-sound. It is his belief that tumors like this should be removed rather than accommodated because if left alone the tumor could continue to grow/mulitply and inter-twine with more nerves...making future removal more difficult. And I tend to agree.

I mentioned to this new podiatrist the issue about my original podiatrist making the statement of me 'not really needing the plantar facia' and idea that the plantar facia is like the 'appendix of the foot'. Because this new podiatrist knows my original podiatrist, I told him that this statement came from someone on the Internet...as I don't want to tarnish a reputation...in case it was a misunderstanding. When I told the new podiatrist this statement he replied, ' I hope that person wasn't a podiatrist....if so they should have thier license revoked!' By the way this new podiatrist said my original podiatrist is respected and known to have a good practice.

The bottom line is that I am delaying the surgery and set up another appointment with my original podiatrist to re-discuss. If I do not feel comfortable with that discussion I will seek out another podiatrist.
Thanks!

Re: Plantar Fibroma

Dave R on 9/24/02 at 20:43 (096146)

That was my feeling too! When I questioned this he said 'you don't really need it.....the plantar facia is thought to be an extention of the achilles tendon' At that point I said 'so it's kinda like the appendix of the foot'....and he said 'Yeah'.

I did get a second opinion today and will be talking to my podiatrist to clear up my understanding....if I'm not confortable with the discussion I will seek another podiatrist.
Thanks for your comment!

Re: Plantar Fibroma

Dr. Z on 9/23/02 at 22:04 (096057)

Thre is a fairly high re-occurrence when excising a plantar fibroma. Injection therapy with orthosis is very effective. Surgery varies and some literature related a very high re-occurrence. The funcction of the plantar fascia is very important and removal can and does cause biomechanical dysfunction and possible pain in other areas of the foot. Becareful and beward and get another opinion.

Re: Plantar Fibroma

Julie on 9/23/02 at 23:30 (096065)

Dave

I'm not a doctor, but I can't imagine how a podiatrist could tell you that the plantar fascia serves no function. Even if we'd never heard of the fascia, and knew nothing about it, we'd be able to see from looking at a picture of the structure of the foot that it connects the bones at the ball of the foot with the heelbone and therefore must be supporting the arch.

Please get another opinion.

Re: Plantar Fibroma

Dave R on 9/24/02 at 20:36 (096140)

Thanks for the advice. I did get a second opinion today. The advice was that I do indeed have a plantar fibroma located close to the heel end of the plantar facia. Also he said that he strongly advises removal but suggests an MRI in addition to the ultra-sound. It is his belief that tumors like this should be removed rather than accommodated because if left alone the tumor could continue to grow/mulitply and inter-twine with more nerves...making future removal more difficult. And I tend to agree.

I mentioned to this new podiatrist the issue about my original podiatrist making the statement of me 'not really needing the plantar facia' and idea that the plantar facia is like the 'appendix of the foot'. Because this new podiatrist knows my original podiatrist, I told him that this statement came from someone on the Internet...as I don't want to tarnish a reputation...in case it was a misunderstanding. When I told the new podiatrist this statement he replied, ' I hope that person wasn't a podiatrist....if so they should have thier license revoked!' By the way this new podiatrist said my original podiatrist is respected and known to have a good practice.

The bottom line is that I am delaying the surgery and set up another appointment with my original podiatrist to re-discuss. If I do not feel comfortable with that discussion I will seek out another podiatrist.
Thanks!

Re: Plantar Fibroma

Dave R on 9/24/02 at 20:43 (096146)

That was my feeling too! When I questioned this he said 'you don't really need it.....the plantar facia is thought to be an extention of the achilles tendon' At that point I said 'so it's kinda like the appendix of the foot'....and he said 'Yeah'.

I did get a second opinion today and will be talking to my podiatrist to clear up my understanding....if I'm not confortable with the discussion I will seek another podiatrist.
Thanks for your comment!