The anatomy of the anterior superior process of the calcaneus was studied from 15
fresh amputation specimens and from two cases of surgical intervention of fractures
of this process. Specific anatomic relationships exist between the associated
ligamentous attachments and the production of fractures of this process. It was found
that both the anterior interosseus talocalcaneal and calcaneocuboid ligaments were
tight on inversion and on inversion plus plantarflexion, suggesting that both of
these ligaments may play a part in the production of avulsion fractures of the
anterior calcaneal process.
The relationship between the articular facets of the calcaneal process, including the
inconstant anterior talocalcaneal facet, and the occasional unexpected poor results
encountered with these fractures is described. Finally, the local anatomy is
correlated with tarsal coalitions found in this area.
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References
1.
. AhlbergA.Stüdien über 111 nachuntersuchte Fälle von Calcaneusfracturen.Göteborg, Tr. Elander1940 (English summary, pp.
278–288).
2.
. BackmanS.JohnsonS. R.Torsion of the foot causing fracture of the anterior calcaneal
process.Acta Chir. Scand., 105:
460–466, 1953.
3.
. BöhlerL.The Treatment of Fractures, Vol. 30. New York, Grune & Stratton,
1958, pp. 2045–2114.
4.
. BradfordC. H.LarsenI.Sprain-fractures of the anterior lip of the os calcis.N. Engl. J. Med., 244:
970–972, 1951.
5.
. BraunbehrensH. vonAbbruch an der Facies articularis anterior calcanei, ein Beitrag zur
Mechanik der Fersenbein-brüche.Dtsch. Z. Zsch. Chir., 245:
359–370, 1935.
6.
. BrownJ. E.The sinus tarsi syndrome.Clin. Orthop., 18:
231–233, 1960.
7.
. BryceT. H. In Quain's Elements of Anatomy, 11th Ed., Vol.
4, Part 1: Osteology and Arthrology.
London, Longmans, Green, and
Co., 1915, p. 271.
8.
. BryceT. H. In Quain's Elements of Anatomy, 11th
Ed., Vol. 4, Part 1: Osteology and Arthrology.London, Longmans, Green, and
Co., 1915, pp.
276–277.
9.
. CahillD. R.The anatomy and function of the contents of the human tarsal sinus and
canal.Anat. Rec, 153: 1–18,
1965.
10.
. CaveE. F. (ed.) Fractures and Other Injuries.Chicago, Year Book Medical Publishers,
Inc.1958, pp. 607–609.
11.
. ChristopherF.Fracture of the anterior process of the calcaneus.J. Bone Joint Surg., 13:
877–879, 1931.
12.
. ConnH. R.The treatment of fractures of the os calcis.J. Bone Joint Surg., 17:
393–405, 1935.
. DachtlerH. W.Fractures of the anterior superior portion of the os calcis due to
indirect violence.Am. J. Roentgenol., 25:
629–631, 1931.
15.
. DeBoldC.Jr.StimsonB. B.Treatment of injuries involving the subtalar joint.Am. J. Surg., 93:
604–608, 1957.
16.
. DeganT. J.MorreyB. F.BraunD. P.Surgical excision for anterior-process fractures of the
calcaneus.J. Bone Joint Surg., 64A:
519–524, 1982.
17.
. DubauR.BolotF.Sur onze observations de tubercu-lose sous astragalienne chez d'adulte
jeune.Presse Med, 48:
519–521, 1940.
18.
. EikinT.De traumatiske Frakturer af Fodrodens Knogler.Copenhagen, Jacob Forlag
Lunds1917, pp. 127–131.
19.
. Essex-LoprestiP.The mechanism, reduction technique, and results in fractures of the os
calcis.Br. J. Surg., 39:
395–419, 1952.
20.
. FinderJ. G.HussussianJ. G.LevinB.Promontory fractures of the calcaneus.J. Int. Coll. Surg., 35:
84–90, 1961.
21.
. GellmanM.Fracture of the anterior process of the calcaneus.J. Bone Joint Surg., 33A:
382–386, 1951.
22.
. GreenW.Fractures of the anterior-superior beak of the os
calcis.N.Y. State J. Med., 56:
3515–3517, 1956.
23.
. GruberW.Über das erste intermetatarsalgelenk des Menschen, mit
vergleichend-anatomischen bemerkungen. Mem. de I'Acad. Impér. des
Sciences de St.-Pétersbourg, Tome XVII, 1871.
24.
. HallM. C.The normal movement at the subtalar joint.Can. J. Surg., 2:
287–290, 1959.
25.
. HoerrN. L.PyleS. I.FrancisC. C.Radiographic Atlas of Skeletal Development of the Foot and Ankle.Springfield, III., Charles C
Thomas1962, p. 104.
26.
. HuntD. D.Compression fracture of the anterior articular surface of the
calcaneus.J. Bone Joint Surg., 52A:
1637–1642, 1970.
27.
. HyrtlJ.Über Die Trochlearfortsätze der Menschlichen Knochen.Mit 4 Tafeln. Denkschriften de Kaiselichen Akademie Der
Wissenschaften.18: 141–156, Wien,
1860.
28.
. JaekleR. F.ClarkA. G.Fractures of the oscalcis.Surg. Gynecol. Obstet., 64:
663–672, 1937.
29.
. JonesF. W.Structure and Function as Seen in the Foot.London, Baillière, Tindall and
Cox1944, pp. 86–87.
. KeyJ. A.ConwellH. E.The Management of Fractures, Dislocations, and Sprains, 4th Ed.St. Louis, C. V. Mosby
Co.1946, p. 1252.
32.
. KyneP. J.MankinH. J.Changes in intra-articular pressure with subtalar motion with special
reference to the etiology of peroneal spastic flat foot.Bull. Hosp. Joint Dis., 26:
181–186, 1965.
33.
. LaidlawP. P.The varieties of the os calcis.J. Anat. Physiol. (London), 38:
133–143 (incl. Plates 11–15),
1904.
34.
. LaidlawP. P.The os calcis. Part II.J. Anat. Physiol. (London), 39:
161–177 (incl. Plates 33–37),
1905.
35.
. LastR. J.Specimens from the Hunterian collection.7. The subtalar joint. J. Bone Joint Surg., 34B:
116–119,1952.
36.
. LevineJ.KerimA.SpinnerM.Non-union of a fracture of the anterior superior process of the
calcaneus.J. Bone Joint Surg., 41A:
178–180, 1959.
37.
. MagnusenP. B.StackJ. K.Fractures., 5th Ed.Philadelphia, J. B. Lippincott
Co.1949, p. 382.
38.
. MorelJ.Variétés Anatomo-clinique et Prognostic des Fractures du Calcanéum.Thèse, Lyon1904.
39.
. PfitznerW.Beiträge zur Kenntniss des menschlichen
Extrem-itstenskelets.VII. Die Variationen im Aufbau des Fusskelets. Hierzu Tafel 8–15. Morphol.
Arbeit, Jena, 6: 17–527,
1896.
40.
. PiattA. D.Fracture of the promontory of the calcaneus.Radiology, 67:
386–390, 1956.
41.
. PoirierP. (ed.): Traité d'Anatomie Humaine. Paris, L. Battaille et Cie,
1894, Tome Premier, p.
706.
42.
. RetziusA.Bemerkungen über ein schleudeförmiges Band in dem Sinus tarsi des
Menschen und mehrerer Thiere.Arch. Anat. Physiol. Wissenschr., 8:
497–505, 1841.
43.
. RockwoodC. A.GreenD. P. (eds.): Fractures, Vol. 2.
Philadelphia, J. B.
Lippincott, 1975, pp.
1417–1418.
44.
. Rosendahl-JensenS.Fractura calcanei.Prognosis of an insurance material. Acta Chir. Scand.,
112: 69–78,
1955.
45.
. RoweC. R.SakellaridesH. T.FreemanP. A.SorbieC.Fractures of the os calcis.A long-term follow-up study of 146 patients. J. A. M. A.,
184: 920–923,
1963.
46.
. RubinG.WittenM.The subtalar joint and the symptom of turning over on the
ankle.A new method of evaluation utilizing tomography. Am. J. Orthop.,
4: 16–19,
1962.
47.
. RüdingerN.Die Anatomie des Peripherischen Nervensys-tems des
Menschlichenkörpers.Stuttgart, Thieme1870.
48.
. SeymourR. B.A study of the astragalus. Part I.J. Anat. Physiol. (London), 38:
233–247 (incl. Plates 19–22),
1904.
49.
. SeymourR. B.A study of the astragalus. Part II (incl. Plates
37–43).J. Anat. Physiol. (London), 38:
423–434, 1904.
50.
. SeymourR. B.A study of the astragalus. Part III (incl. Plates
20–23).J. Anat. Physiol. (London), 39:
74–87, 1905.
. TrolleD.Accessory Bones of the Human Foot.Copenhagen, Einar
Munksgaard1948, pp. 1–272.
56.
. WarrickC. K.BremnerA. E.Fractures of the calcaneum.With an atlas illustrating the various types of fracture. J. Bone Joint
Surg., 35B: 33–45,
1953.
57.
. Watson-JonesR.Fractures and Joint Injuries, 5th Ed., Vol.
2, WilsonJ.N. (ed.), London,
Churchill Livingstone1976, p. 1166.
58.
. WidenA.Fractures of the calcaneus.A clinical study with special reference to the technique and results of open
reduction. Acta Chir. Scand. [Suppl.], 188:
78–79, 1954.
59.
. ZacharinD.Fracture of the anterior process (promontory) of the
calcaneus.Med. J. Aust., 50:
737–738, 1963.
