Nothing is worse than constant pain in your feet, especially since you can’t just stop using them while they heal!
Plantar fibroma might not cause pain initially, but as it progresses, it may reach the stage where your doctor recommends surgery to improve your quality of life.
Here’s everything to know about plantar fibroma surgery. Whether your medical professional has recommended it or you’re considering it because your pain is so severe, this should tell you all you need to know before it happens.
What Is Plantar Fibroma Surgery?
Plantar fibroma surgery is the surgical removal of a plantar fibroma—or fibromas—from the tissue of the foot. There are different types of surgeries, depending on the severity of the fibroma.
The goal of the surgery is to remove the actual mass, but in some cases, the surgeon may remove some of the tissue around the fibroma as well. The entire plantar fascia ligament may be removed in very severe cases, but this is rare.
Why Is It Necessary?
Sometimes plantar fibromas won’t respond to conservative treatment, like orthotics, massage, ice treatment, NSAIDS, or cortisone injections.
In some cases, the fibroma grows so much that it hampers your foot’s movement, ability to bear weight, or normal everyday tasks. Fibromas of this severity may need to be surgically removed for you to continue performing your daily tasks without pain.
Another case in which surgery may be considered is if the nodules underneath your feet multiply. However, more conservative treatment is recommended until the need for surgery arises.
What Is the Success Rate of Surgery?
The success rate of plantar fibroma surgery depends on what surgery you get done. If you get a local excision surgery—removal of just the fibroma itself—it has a 100% chance of recurring.
For full plantar fasciectomies, the chance of recurrence is only 25%. However, this is a more serious surgery and takes much longer to recover from. It can also have more severe long-term consequences, including numbness of the foot and collapsing of the arch.
Types of Plantar Fibroma Surgery
There are numerous types of plantar fibroma surgery. Your one will depend on your doctor’s assessment of the fibroma and its severity.
This is the most minimal of all the surgery options. An incision is made in the bottom of the foot and only the fibroma itself gets removed. It’s also the easiest and quickest to recover from.
Some surgeons prefer a minimally-invasive procedure using a hollow-tipped ultrasonic wand, which breaks up and removes the tissue of the fibroma without the need for a large incision.
A wide excision removes the whole fibroma as well as an area of roughly 1/10th of an inch of the tissue around it. This is also a fairly minimal procedure and doesn’t take long to recover, although the incision site requires some time off your feet to heal properly.
Partial Plantar Fasciectomy
In a partial plantar fasciectomy, the inflamed section of the plantar fascia is removed along with the plantar fibroma. This is often done when there’s already scarring to the plantar fascia.
Full Plantar Fasciectomy
This surgery is the biggest of them all and involves the entire plantar fascia being removed. While it does have the highest success rate, it’s performed extremely rarely, due to the long-term effects of missing the plantar fascia ligament in your foot.
Benefits of Plantar Fibroma Surgery
If conventional treatments did nothing to relieve the pain and discomfort of your fibroma, you’ll immediately feel the benefits of plantar fibroma surgery.
The fibroma area will be sore and swollen for a few days up to a few weeks. But the relief will be immediately noticeable once your doctor gives you the go-ahead to begin walking again.
You’ll find that the pressure of the fibroma is removed, and your pain levels should significantly improve. You may be able to wear shoes that you couldn’t wear before because they hurt your feet, and bearing weight will be much less painful.
If you’re able to have minimally-invasive surgery—excision with an ultrasonic wand—the benefits are greater. You’ll see a shortened recovery period, you won’t need to go under an anesthetic, and the risk of infection and scarring is greatly reduced.
How to Prepare for Plantar Fibroma Surgery
There’s very little you can do to prepare for the upcoming surgery other than to keep your feet clean! However, you need to be aware that you will need to spend some time off your feet after your surgery, so you must make arrangements at work.
If you do manual labor or work on your feet all day, you will need 4 to 6 weeks off work for the plantar fascia to heal.
If you return to work sooner and bear weight on the surgery site—especially for many hours at a time—you may risk damaging the plantar fascia, opening yourself up to infection, or creating scar tissue that may need to be removed later.
If you don’t do manual labor or spend hours on your feet, you should plan for 2 to 4 weeks off from work. This is the time to rest your foot and allow the plantar fascia and surrounding tissues to heal properly before you place pressure on them again.
Provided your surgery happens early in the day, you should be able to go home later that same day. Only overnight stays should be required if your surgery falls late in the afternoon.
Plantar Fibroma Surgery Recovery May Look Something Like the Following:
Everybody is different, and so is every surgery. So it’s difficult to say what recovery might look like for every person. However, this is what you may expect in the days, weeks, and months going forward from partial plantar fasciectomy surgery.
If you have a more simple excision surgery, you can expect healing and recovery to be much faster. On the other hand, if you have a full plantar fasciectomy, recovery may take longer and is likely to include physiotherapy.
Whichever kind of surgery you’ve had, it’s important to listen to your doctor’s advice and move through your recovery period as per their instruction.
Partial Plantar Fasciectomy Recovery Period
Day 1 to 4
You will need to rest your foot completely for at least 2 days after surgery, up to 4 if necessary. If you need to move around, use crutches and keep weight off your affected foot. You will be given NSAIDS for pain relief during the first few days.
Day 5 to 14
During this period, you must return to the hospital for your foot to be assessed and redressed. Your doctor will show you gentle exercises to keep your foot mobile.
Day 21 (3 Weeks)
At this point, the sutures can be removed from the foot. You may be able to place weight on the foot, however, if you feel pain you should go back to crutches. If the wound has healed to the doctor’s satisfaction, you may be able to wear shoes again.
3 to 12 Weeks
In this period of time, you should notice the swelling going down, although it may flare up again at the end of the day. You should be able to return to work and may be able to drive if the wound has healed well. Sports should be avoided until at least 3 months after the surgery.
6 to 12 Months
You should have a final assessment with your doctor between 3 and 6 months after surgery. Between 6 and 12 months, the final healing of the foot will occur.
Full Plantar Fasciectomy Recovery Period
You can expect to be off your feet for longer if you’ve had the full plantar fascia ligament removed. You may need to report back to your doctor more often to check and redress the wound.
There’s a high chance that the doctor will refer you to a physiotherapist rather than just giving you home treatment exercises. You may also need to make some lifestyle changes, such as wearing more cushioned, soft shoes or orthotics. Once the foot is healed, you may need to wear stability shoes rather than neutral shoes.
Plantar Excision Recovery Period
You can expect the healing process to be faster for a less invasive surgery. You should still rest the foot for the prescribed 2 to 4 days, but you’re more likely to be able to get back to normal levels of work and life after just a few weeks.
You can help speed up the healing process during recovery by taking certain actions. These may include:
- Using crutches to get around without placing excess pressure on the foot
- Calf stretching exercises to ease tension in the plantar fascia
- Gentle weight-bearing with a soft-soled shoe—stop if you feel pain
- Massaging gently to prevent scar tissue from forming
- Stretching and strengthening exercises to increase circulation and reduce inflammation
- Keep your feet clean and dry, especially as the incision heals
How Can I Prevent Plantar Fibroma from Returning After Surgery?
It’s almost impossible to prevent a fibroma from developing—especially if you’ve already had one—but you can take some steps to make it less likely to happen.