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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 2004 September;28(3):121-6
Peroneus longus tendon spontaneous rupture distal to os peroneum. Case report
Bonicoli E., Cesqui C., Bonicoli F.
Pathogenesis of peroneus longus tendon sponteneous rupture , described in literature, isn't still clear. One or more factors could be discussed: mechanical causes, like a ripetitive trauma in a cavo-varus foot, a conflict between morphologic anomalies, congenital or acquired between tendon, sesamoid bone and sulcus cuboidei, finally tendinosis and tendinitis. In the present paper, we describe a unusual case of peroneus longus tendon sponteneous inveterate atraumatic rupture distal to os peroneum. We point out clinical findings and radiological test and how a comparative x-ray of the feet can be diagnostic when the os peroneum is ossified, showing the submalleolar position of sesamoid bone of the painfull foot. The particular anatomical pathway predisposes peroneus longus tendon to rupture between esternal peroneal malleolar groove and peroneal tubercle of calcaneum or at the begining of sulcus cuboidei, in particular when there is an association with a mild cavo foot, like in our case. The surgical management has been a tenodesis of peroneus longus with peroneus brevis because of the part of the tendon distal to sesamoid was strongly degenerate and there was a few centimetrical gap. The lost of peroneus longus function has not damaged the result after 1 year.