Wapner K L, Ververeli P A, Moore J H, Hecht P J, Becker C E, Lackman R D
Department of Orthopaedic Surgery, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Foot Ankle Int. 1995 Sep;16(9):548-51. doi: 10.1177/107110079501600906.
Plantar fibromatosis can be quite disabling to the patient, as well as a technical challenge to the surgeon. Patients who undergo previous local excisions and in whom aggressive recurrences develop are difficult to manage successfully. We present a consecutive series of five primary procedures on patients with painful plantar fibroma and seven revision operations on patients with recurrent plantar fibroma. The average follow-up was 47 months (range, 22-66 months) in the primary group and 40 months (range, 21-78 months) in the revision group. The overall results were satisfactory in four of the five primary operations, with only one recurrence. In the revision group, five of seven results were satisfactory with no recurrences. The major complication that led to unsatisfactory results was the development of a postoperative neuroma. In this article, we outline our present surgical techniques of wide primary excision and a staged revision procedure with delayed split-thickness skin graft closure. These techniques can be used successfully to manage this disabling, progressive disease.
足底纤维瘤病对患者而言可能极具致残性，对外科医生来说也是一项技术挑战。那些曾接受过局部切除且出现侵袭性复发的患者很难得到成功治疗。我们连续介绍了针对患有疼痛性足底纤维瘤患者的5例初次手术以及针对复发性足底纤维瘤患者的7例翻修手术。初次手术组的平均随访时间为47个月（范围22 - 66个月），翻修手术组为40个月（范围21 - 78个月）。5例初次手术中有4例总体结果令人满意，仅1例复发。在翻修手术组中，7例中有5例结果令人满意且无复发。导致结果不理想的主要并发症是术后神经瘤的形成。在本文中，我们概述了目前广泛初次切除的手术技术以及采用延迟分层皮片移植闭合的分期翻修手术。这些技术可成功用于治疗这种致残性、进行性疾病。
