Calcaneum talar facets, its diagnostic and clinical relevance to fracture

Abstract

IntroductionCalcanei are classified into three to five patterns according to the number of superior articular facets present. As reported earlier the relative distribution of facets pattern varies with race and sex. Study of the calcaneal talar facets variation is important because it influence subtalar joint stability and knowledge of facets is essential while correcting foot deformities and for placing the screw in fracture fixation by orthopaedic surgeons. Material & methodFor this study sixty calcanei of human cadaver were procured from various sources. The calcanei were observed for patterns of the talar articular facets and the separation between the facets. ResultIn this study, only three patterns were described. Pattern I calcanei bear three facets for the talus, Pattern II calcanei bear two and Pattern III calcanei a single facet only. This study is important with the view that fracture involved facet and lead to decrease in calcaneal axial length. DiscussionAn understanding of the complex surgical calcaneal anatomy begins with a 3-D appreciation of the multiple articulations and bony processes. Calcaneal reconstruction is predicted on the restoration of the articular surfaces especially the posterior facet, appropriate reconstruction of the 3 dimentional spatial relationship between three articular facets is of paramount importance. Nature of calcaneal bone (spongy or dense) is important for orthopaedic surgeon in fracture fixation, calcaneum is harder beneath the posterior facet. Distance between anterior and middle facet is important for calcaneal lengthening osteotomy without violating the subtalar joint.