关键词: 跟骨, 载距突, 解剖学, 测量, 骨折内固定术

Abstract:

Objective　To explore anatomic relationship of the anterior part of calcaneus and sustentaculum tali, and the feasibility of screw insertion from anterolateral wall of calcaneus into sustentaculum tali.　Methods　36 calcaneus specimens were performed anatomic measurement, digital radiography and computed tomography, respectively.  The special focus was on the anatomic parameters of the anterior part of calcaneus and sustentaculum tali. The screw insertion point and direction from anterolateral wall of calcaneus into sustentaculum tali were decided through the simulated operation. Meanwhile, the safety of screw insertion was evaluated.　Results　Anterior part of calcaneus closely related to sustentaculum tali. The length, width and height of them were (22.27±2.96)mm and (24.24±2.27)mm, (23.60±1.99)mm and (15.44±1.41)mm, and （25.25±3.03)mm and (10.96±1.25)mm, respectively. The anteversion and extraversion angles were（39.13±5.28）°and （27.78±4.36）°respectively. Two sites were selected as screw insertion point from the anterior part of calcaneus to the sustentaculum tali. For anterior point, the superior and inferior oblique angles were（21.37±3.35）°and （22.39±3.13）°respectively,  with the effective fixation length of (43.46±2.12）mm. For posterior point, the superior and posterior oblique angles were （33.60±4.15）°and （10.09±1.03）°respectively, with the effective fixation length of （44.69±2.32）mm. No screws penetrated through the cortex of the anterior part of calcaneus.　Conclusions　Sustentaculum tali is a ideal position for screw insertion for treating calcaneal fracture. Screws can be inserted safely into sustentaculum tali from anterolateral wall of calcaneus. The angles of insertion and the screw length are determined by the anatomic relations between them. Our work provide anatomical basis for internal fixation for treating calcaneal fracture.

Key words: Calcaneus, Sustentaculum tali, Anatomy, Measurement, Internal fixation