Ledderhose's disease

Ledderhose's Disease, also known as Morbus Ledderhose, plantar fibromatosis, and plantar aponeurosis, is a non-malignant thickening of the feet's deep connective tissue, or fascia. In the beginning, where nodules or cords start growing along tendons of the foot, the disease is minor, or not painful. Eventually, however, the cords thicken, the toes stiffen and bend, and walking becomes painful. The disease is named after Georg Ledderhose (1855 - 1925), a German surgeon who described the condition for the first time in 1897.

Ledderhose's disease is the equivalent disease to Dupuytren's disease, which affects the hand and causes bent hand or fingers. As with Dupuytren's disease the root causes of Ledderhose's disease are not yet understood, though an inclination is probably inherited. Men typically get the disease at an earlier age than women. At the age of 80 the probability to suffer from Dupuytren's disease becomes about even for men and women (we have no statistics on Ledderhose's disease), with men typically in a more progressed stage.

Surgery of Ledderhose's disease is difficult because tendons, nerves, and muscles are located very closely to each other. Additionally, feet have to carry heavy load, and surgery might have unpleasant side effects. If the disease has not progressed too far, radiation therapy has proven to relieve and even cure Ledderhose's disease. Triamcinolol acetonid (triamcinolone; brand names e.g. Kenalog, Aristocort or Triderm) is injected to soften nodules and reduce their size. In few cases shock waves also have been reported to at least reduce pain and enable walking again. Currently in the process of FDA approval is the injection of collagenase. Recently successful treatment of Ledderhose with cryosurgery (also called cryotherapy) has been reported.