Autogenous free dermal fat grafts in the surgical approach to plantar fibromatosis

Abstract

Plantar fibromatosis is a benign disorder of the foot in which there is fibrous tissue infiltration of the plantar aponeurosis and in some cases the overlying skin. Treatment is indicated for pain and functional gait disturbance. Even with wide fascial resection, recurrence with spreading, scarring, and continued discomfort can be a frustrating and difficult problem. Various techniques to lessen recurrence have included split-thickness skin grafting and Marlex mesh placement. However, these procedures have documented problems, including recurrence, foreign-body reaction, scarring, and inadequate soft-tissue coverage. The authors introduce dermal fat grafting following primary excision as a means to minimize recurrence while maintaining the anatomic architecture of the foot and preserving a soft, supple weightbearing surface with minimal scar tissue formation.