Ledderhose disease is a pathology in which tubercles appear on the foot. The disease was first described in 1894 by the German surgeon Georg Ledderhose. Nodules on the soles of the feet cause the patient great discomfort when walking. Otherwise, this pathology is called plantar fibromatosis. How to get rid of such a disease? This issue is considered in the article.
What it is
Plantar fibromatosis is a disease accompanied by the appearance of benign tumors on the foot. They arise due to the proliferation and compaction of connective tissue in the tendons. Tumors look like elastic nodules and are made up of collagen fibers.
In the initial stages, Ledderhose disease does not cause particular inconvenience to the patient. However, as fibroids grow, a person begins to experience pain and severe discomfort when stepping on the sole. In addition, it becomes difficult for the patient to bend his toes.
Most often, fibromatous tumors appear on only one foot. In some cases, the pathology affects both limbs. In left-handed people, nodules usually form on the left foot. Ledderhose disease is often observed in men older than 45 - 50 years.
Causes
The exact causes of the pathology have not been established. It is assumed that nodules on the tendons are formed due to poor circulation in the foot, impaired calcium metabolism and hormonal disruptions. The following categories of patients are at risk for the occurrence of Ledderhose disease:
- middle-aged and elderly men;
- patients with diabetes;
- patients who have suffered leg injuries;
- alcohol abusers.
The likelihood of nodule formation increases with regular heavy loads on the legs. The following medications can also provoke the occurrence of pathology:
- anticonvulsants;
- the drug "Phenytoin";
- beta blockers;
- some dietary supplements.
There are cases when nodules are initially formed on the palms. Such patients also have an increased risk of the appearance of fibromas on the soles.
Symptomatology
How is Ledderhose disease manifested? There are several stages of pathology:
- 1st stage. At first, fibroids are practically invisible. They can only be determined using special diagnostics. They do not cause the patient any inconvenience.
- 2 stage. Nodules grow. On the foot, tubercles are visible. They are especially noticeable when bending your fingers. There is pain and discomfort when walking.
- 3 stage. Compaction of the foot tissue progresses. Nodules begin to give to the muscles and nerve endings. It becomes difficult for the patient to flex and extend his fingers. Because of this, severe gait disorders occur, lameness develops.
Diagnostics
How to identify plantar fibromatosis? It is necessary to consult an orthopedic surgeon or surgeon. Specialists usually diagnose this disease with external examination and palpation of the foot.
In some cases, it is necessary to differentiate plantar fibromatosis from other types of benign and malignant tumors. For this purpose, MRI of the foot is prescribed. This examination allows you to determine the structure of the neoplasm, the size of the fibroma and the depth of the tendon lesion.
You must also tell your doctor about the medications you are taking. In some cases, plantar fibromatosis occurs due to side effects of drugs.
Conservative therapy
How to treat Ledderhose disease? At the initial stages of the pathology, the use of conservative therapy is possible.
Patients should reduce the load on their legs. Doctors also recommend using soft insoles for shoes. This reduces walking discomfort.
To relieve pain, hormonal ointments are prescribed:
- Clobetasol;
- "Dexamethasone";
- "Triamcinolone".
In complex cases, injections of corticosteroid drugs are indicated. However, such treatment is symptomatic. Glucocorticoids help relieve pain, but do not affect the cause of the disease.
More promising is the treatment of Ledderhose disease with Dimexide. This drug is applied to a sore spot in the form of a compress. It relieves inflammation and pain, and also contributes to the gradual resorption of nodular formations.
Modern methods
Nowadays, new methods have been developed for the treatment of plantar fibromatosis. Collagenase-based injections give good results. This substance is an enzyme that breaks down proteins of connective tissue. It is injected directly into the affected area. This leads to the rapid resorption of collagen nodules, the disappearance of pain and the restoration of finger movements.
Physiotherapy
In addition to drug therapy, patients are prescribed foot massage. However, this procedure should not be done independently. It is better to trust an experienced massage therapist. The impact on the sole should be very gentle and accurate. In no case should you press on the tubercles. During the massage, carefully stretch the muscles of the foot. This will cause blood flow to the affected area and will help reduce pain.
Physical therapy is also recommended. The doctor individually selects exercises for each patient. When performing gymnastics, it is necessary to evenly distribute the load on the right and left foot. Treatment of Ledderhose disease with exercise therapy gives good results in combination with drug therapy and massage procedures.
Surgical intervention
It is indicated for advanced forms of plantar fibromatosis, as well as in the absence of the effect of conservative treatment. Surgical intervention is also necessary for violation of flexion and extension of the fingers.
Under local anesthesia, the surgeon removes the fibroma. Tissues are sent for histological examination to determine the nature of the tumor. The operation does not last long, but it requires a highly qualified doctor. After all, nodules are located in close proximity to nerves and blood vessels.
Rehabilitation after removal of fibroma lasts about 14 days. In the first time after surgery, the patient should use a walker. Subsequently, normal movement is restored. The patient is recommended to put soft insoles in the shoes to reduce the load on the sole.
Surgery has its drawbacks:
- relapses of plantar fibromatosis often occur;
- flat feet may develop;
- after the operation, a painful suture remains, which also needs to be removed.
In some cases, after the operation, patients are prescribed a course of radiation therapy. This helps to avoid the re-formation of fibromas.
Prevention
Can plantar fibromatosis be prevented? Modern medicine does not know the exact causes of nodules on the tendons of the foot. Therefore, specific prevention of this disease has not been developed. Surgeons give the following recommendations:
- Do not create excessive load on the legs;
- wear comfortable shoes with soft insoles;
- give up alcohol;
- regularly do leg exercises;
- heal lower limb injuries in time;
- Do not abuse drugs and dietary supplements.
These measures will help reduce the risk of nodules on the tendons.