Ledderhose disease: an operation with Doctor Julien Lopez

Do you suffer from Ledderhose? Sometimes an operation is necessary to reduce the plantar discomfort. Doctor Lopez can help you with this condition.

The treatment of ledderhose disease by surgery is sometimes considered depending on the discomfort and after consultation with a foot specialist. It is a disease caused by the formation of nodules under the foot, at the level of the plantar arch. Also called plantar fibromatosis, this disease comes from the thickening of the fascia. When this membrane protecting the inner arch becomes thicker, nodules are formed at the soles of the feet: these are the nodules of the ledderhose.

This condition of a certain rarity causes everyday discomfort to be more or less important depending on the size and the extent of the nodules. Doctor Julien Lopez studies your case with expertise to adapt your treatments, whether non-surgical or surgical. Depending on this study, a ledderhose nodule operation may be considered.

Ledderhose disease: non-surgical treatment, causes and risk factors

In order to treat ledderhose disease, non-surgical treatment may be sufficient. This plantar pathology has several causes and risk factors.

Men over 40 are more likely to develop this condition. The causes remain unknown but some factors seem to encourage its development:

• Heredity in 30-50% of cases
• If the individual is diabetic or has alcoholic tendencies
• Certain drug treatments such as isoniazid and barbiturates
• Fractures, strain injuries and surgical procedures in this area of the foot

This condition is very often linked to the disease of Dupuytren or La Peyronie, fibromatoses reaching respectively the hand and the shaft.

Certain actions can slow down the development of ledderhose disease, an operation can then be avoided. Avoiding wearing shoes that are too narrow or too large can reduce the risk of new nodules. Opting for models really adapted to your plantar morphology, adopting a balanced diet and practicing a regular sports activity allows you to avoid a rapid development of this condition.

Depending on your symptoms, Doctor Julien Lopez will choose a treatment that is specifically adapted to your situation: medical or surgical, it will depend on the diagnosis made.

In case of ledderhose, surgery is sometimes necessary

Depending on the symptoms and extent of your ledderhose, surgery is sometimes the only solution. Doctor Julien Lopez will examine your foot and assess the discomfort in order to offer you the best solution for your situation.

The diagnosis is given after a clinical examination, looking for clinical signs of ledderhose disease, by a specialist. The doctor makes a palpation of the nodules present to determine the nature. Indeed, the analysis of their elasticity and firmness coupled with a thorough examination can help to make a diagnosis. Examinations may also be requested in addition to ultrasound or magnetic resonance imaging (MRI).

Most often, the nodules are located at the level of the plantar arch and can cause discomfort when walking. In the long term, inflammation can form causing sharp pain every time the foot touches the floor.

Depending on your situation, Dr. Julien Lopez may decide whether to implement a treatment depending on the progress of your disease. Indeed, if the movement is strongly affected, an operation of a ball of ledderhose disease may be an option.

If no pain or discomfort is disturbing your daily life, no treatment is necessary. However, regular monitoring will be maintained to detect any discomfort. Physiotherapy sessions as well as plantar orthotics (orthopedic soles) may also be prescribed to relieve the areas of the sole of the foot on which you rely, which are often painful.

In case of ledderhose disease, local medical treatment such as corticosteroids or injections may also be prescribed and performed by your doctor to relieve the discomfort.

Nevertheless, when the discomfort and pain become too great and it becomes hard to function, a surgery operation of the ledderhose disease can be considered.

Doctor Julien Lopez, specialist of ledderhose disease

As a specialist in ledderhose disease, Doctor Julien Lopez performs partial or total surgical operations to eliminate the discomfort caused each time you place your foot on the floor.

Surgery of the ledderhose called apovrectomy or fasciectomy is usually performed under local anesthesia. It involves sectioning and removing the nodules at the plantar arch. Doctor Julien Lopez will form a bandage in the form of compression to avoid hematomas, just after closing the wound.

Any operation and any treatment admits risks, those of the aponévrectomie are the following:

• Nerve or vascular damage may occur, very rarely
• A new appearance of nodules, requiring a resumption of operation of the additional ledderhose

In post-surgery, Doctor Julien Lopez recommends walking with caution because the bandage is often placed on the scar: you must remain careful until healing is complete (3 weeks on average). During 3 to 4 weeks, major efforts should be avoided and those actions which demand intense movement of the foot, for 6 weeks.

To eliminate any discomfort and pain, call Doctor Julien Lopez, a specialist in ledderhose disease.

Caption photo: Case of advanced ledderhose disease with significant retraction and fixed claw of the big toe (see photo Ledderhose)