Literature on Ledderhose disease (Ledderhose's disease)

An overview of plantar fibromas can be found at plantar_fibromas (Podiatry Today).

Van der Veer WM, Hamburg SM, de Gast A, and Niessen FB collected results on "Recurrence of plantar fibromatosis after plantar fasciectomy: single-center long-term results" Plast Reconstr Surg. 122 (2008) p 486-91 abstract and conclude "Surgical treatment of plantar fibromatosis is associated with a high recurrence rate and indicated only when the lesions are highly symptomatic and conservative measures fail. Total plantar fasciectomy is the most successful treatment in this study, particularly for primary lesions. The role of postoperative radiotherapy should be evaluated further." Similar conclusion are drawn by J Beckmann et al. "Plantar fibromatosis: therapy by total plantarfasciectomy" Zentralbl. Chir. 129 (2004) p 53-7 English_abstract and German_full_pdf.

An overview of treatment options with emphasis on cryotherapy is given by Terry L Spilken "Cryotherapy and other therapeutical options for plantar fibromatosis" in Ch. Eaton et al. (Eds.) "Dupuytren's Disease and Related Hyperproliferative Disorders" (Springer, New York, 2012), p 401-408, available in printed form and as ebook cryo_chapter. Another discussion of current treatment options is provided by Michael S. Downey and Byron Hutchinson "Point-Counterpoint: Is Conservative Care The Best Approach For Plantar Fibromatosis?" full_texPodiatry Today 26 (2013) p 36-42.

FV Alusio et al. "Plantar fibromatosis: treatment of primary and recurrent lesions and factors associated with recurrence." Foot Ankle Int. 17 (1996) p 672-8 abstract observe recurrrence after 7 months in 25 - 75 % of the analyzed surgeries. The authors conclude "In treating recurrent disease, subtotal fasciectomy was more effective than local or wide excision."

An overview of radiotherapy of Morbus Ledderhose (Ledderhose's disease) was presented on ASTRO 2006 by Seegenschmiedt et al. The authors provided us with a copy of their poster: poster_Ledderhose_ASTRO. More recently Seegenschmiedt et al. published results on "Long-Term Outcome of Radiotherapy for Primary and Recurrent Ledderhose Disease" in Ch. Eaton et al. (eds.) "Dupuytren's Disease and Related Hyperproliferative Disorders" p 409-427 ebook The authors compare the status after ,ore tham 5 years with an untreated control group and clearly demonstrate the benefit of radiotherapy for Ledderhose disease.  -  R. Heyd et al. "Radiation Therapy for Early Stages of Morbus Ledderhose" Strahlentherapie und Onkologie 186 (2010) p 24-29 use x-rays and e-beam. Results: "After a median follow-up of 22.5 months, none of the patients experienced a progression of number and size of the lesions or the clinical symptoms. In eleven sites (33.3%) complete remission of cords or nodules occurred, in 18 (54.5%) a reduced number or size was noted, and four sites (12.1%) were unchanged. Pain relief was achieved in 13/19 patients (68.4%)".

On children affected by Ledderhose (and Dupuytren's) disease: Fetsch JF, Laskin WB, Miettinen M. "Palmar-plantar fibromatosis in children and preadolescents: a clinicopathologic study of 56 cases with newly recognized demographics and extended follow-up information." Am J Surg Pathol. 29 (2005) p 1095-105 abstract . "Our study group included 19 males and 37 females, ranging from 2 to 12 years of age at the time of their first surgical procedure (median age, 9 years) ... All but two of the initial lesions occurred on the plantar aspect of the feet, typically in the region of the arch. Only 2 patients presented with palmar disease." The authors observe a long-term recurrence rate of 84 % after surgery.

Farsetti P, Tudisco C, Caterini R, and Bellocci M. "Ledderhose's disease: case study with histologic and ultrastructural analysis" Ital J Orthop Traumatol. 18 (1992) p 129-33 observe similar stages in disease development as for Dupuytren's disease but without contracture. Eventually the nodules seem to create an increasing amount of collagen ("the extracellular matrix is composed of dense bundles of collagen fibers with few fibroblasts") abstract . In the future this might make collagenase injection a suitable treatment.

For further literature please refer to the pages on radiation therapy, surgery, and "Other therapies". We are not aware of any literature regarding the application of NA to Ledderhose disease.

 

Ledderhose Patients might read this interesting blog on Ledderhose disease: http://www.ledderhose.blogspot.co.uk/. It is very up to date and provides personal experience as well as information on treatment options.


Page last modified: 12/28/2016