Tuesday, 7 February 2012

Surgery for Ledderhose

Surgery to treat plantar fibroma


I thought that it was time for my third post of the different types of treatment that are available for those with Plantar Fibromas. For simplicity I will try to stick to the same layout as I used last time and will try to cover this in as much detail as I can find. Note that I am not a doctor or a specialist and that everything on here is just my experience with the disease and some information from on-line resources and that you should trust what your doctor tells you. I am not responsible for what you chose to do so please don't make your choice based on what you see here and blame me. Of course if any one has more details or thinks something is wrong then be sure to comment or message me. 



How and why does Surgery help a plantar fibroma / ledderhose disease?


So for anyone that cannot guess surgery is a removal of the fibroma from the foot, this of course means no fibroma, no pain right? Well of course things in the foot are always complicated as you take so much weight through them (especially if you weight as much as I do) and therefore a scar in the foot and everything is not a good thing. My understanding is that there are several different options when it comes to surgery see my post here as it is covered slightly in that. But there are three main types that all have their advantages and disadvantages.  Discussing these will be my results part. 


Results:


The first kind is the simple removal of the lump, this has the big benefit of quickest recovery time and is the least invasive so is less likely to have complications but of course there is a down side and that is that you have the highest chance of recurrence which I was told at my recent specialist appointment is about 60%. I have however recently been luckily enough to have the really expensive book about Ledderhose and the related disorders given to me as a gift and this actually states the rate of return as 85% which is crazy high and would make me rule out this kind of surgery as an option. Becky had some useful information on this in the recent interview that I did with her as someone who has had this kind of surgery.


The second kind is a wider resection removal of the lump, the idea behind this is that you are increasing the likelihood of removal of any damaged tissue and therefore you decrease the chances of it coming back. As far as I understand you do have less chance of it coming back but the chances are still quite high (I don't have a %) and of course things are slightly more complicated in terms of surgery and some healthy tissue will be removed so the recovery time will be increased. 


The final kind is, again as best I understand it a type of surgery where they basically remove the entire band along which the Fibromas grow and this reduces the rate of return to a much more acceptable term but increases the likelihood of other problems as you are missing a large chunk of your foot. 

Side Effects: 

The main one is that the lumps frequently grow back and when they do they are often worse. If you have the more intensive surgery then you are most likely going to require orthotics for the rest of your life as you need the extra support for your crippled foot. I have no experience of this kind of thing but I have discussed it with Becky who has had the most minor of the above surgeries but had basically immediate reappearance of the lumps. See my interview from last week to see her experience.


Conclusions:

Everything that I have heard and everyone who I have spoke to about it says to only do this as a last option when you are unable to walk and everything I have seen backs this up. Do NOT take this option likely and if you have this disease and can still walk and your doctor recommends it, well I am not going to say don't go with them but maybe get a second opinion to check. 


References: 




Dupuytren's Disease and Related Hyperproliferative Disorders: Principles, Research, and Clinical Perspectives -

Charles Eaton M. Heinrich Seegenschmiedt Ardeshir Bayat Giulio Gabbiani Paul Werker Wolfgang Wach  

Blog is posted in association with Plantar Fibroma Forum