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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE
A Journal on Physiopathology and Surgery of the Foot
Indexed/Abstracted in: EMBASE, Scopus
Chirurgia Del Piede 2003 March;27(1):11-8
Degenerative tear of coxa pedis glenoid
Parino E., Pisani P. C.
Background. Twelve patients suffering from medial tarsalgia in a clinical picture related to posterior tibial tendon (PTT) dysfunction were operated on, surgical exploration finding a degenerative lesion of the glenoid cartilage fibre. The antomo-pathological pictures went from softening of the medical calcaneo-scaphoid ligamentous component as far as massive rupture.
Methods. In all cases, the rear tibial tendon had preserved its continuity albeit in the presence of tenovaginitic involvement and except for 1 case glenoid rupture was associated with valgus eversion on the foot with lowering of the plantar surface presenting the clinical picture commonly defined as acquired adult degenerative flatfoot deformity. In the presence of softening (malacia) only 1 case developed into valgus eversion while in the other patients the clinical picture suggested only tenopathy of the PTT.
Results. In about half the cases (61%) the accessory scaphoid bone was present. This characterised the glenoid fibro-cartilage which presented malacic or, corresponding to it, a fissurative lesion was evidenced: observation attributable to the possible microtraumatic lesive action of the accessory bone on the glena (association of accessory scaphoid bone with PTT insufficiency in acquired adult degenerative flatfoot deformity).
Conclusions. Degenerative pathology of the coxa pedis glenoid may be considered as a pathological entity in the context of acquired adult degenerative flatfoot and should be included in the differential diagnosis in PTT insufficiency syndrome.