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The Lower Extremities
Published in Melanie Franklyn, Peter Vee Sin Lee, Military Injury Biomechanics, 2017
The talus rests on the anterior two-thirds of the calcaneus (Moore et al. 2011). The calcaneus is the largest and strongest bone of the foot and transmits the majority of the body weight from the talus to the ground. The posterior portion of the calcaneus serves as the insertion point for the Achilles tendon. The head of the talus is supported by the talar shelf of the calcaneus. It also articulates with the navicular. The navicular bone resides on the medial side of the foot and has three strongly concave proximal articular surfaces for each of the three cuneiform bones. The medial, middle and lateral cuneiforms articulate with the first, second and third metatarsal bones, respectively, via a tarsometatarsal joint. Residing medial of the cuneiform is the cuboid bone. The lateral cuneiform and navicular bones articulate with the medial surface of the cuboid bone. The cuboid bone also articulates with the fourth and fifth metatarsal bones forming the tarsometatarsal joint and with the calcaneus proximally at the calcaneocuboid joint. The metatarsals connect the tarsus to the 14 phalanges. Each phalange is constructed of three bones except the first phalange which consists of two bones (Moore et al. 2011).
Biomechanics of calcaneus impacted by talus: a dynamic finite element analysis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Mengquan Huang, Bin Yu, Yubiao Li, Chunlai Liao, Jun Peng, Naiming Guo
Axial compression was identified as the primary cause of calcaneal fractures (Gallenberger et al. 2013; Stephens and Grujic 2020). The fractures were caused by stress on the calcaneus when it was positioned between the ground and the talus during a fall. There were two classic theory on calcaneal fracture (Essex-Lopresti 1952; Carr et al. 1989). Carr et al. (1989) used eighteen cadaveric tibia specimens to model intra-articular calcaneal fractures and found that the fracture comprised of two basic fracture lines. The first fracture line divided the calcaneus into medial and lateral portions, extending to the calcaneocuboid joint and the anterior subtalar articular. The second fracture line divided the calcaneus into anterior and posterior parts, extending from the Gissane Angle to the medial wall of the calcaneus. Essex-Lopresti (1952) suggested that the primary calcaneal fracture line initially formed between the lateral talar process and lateral calcaneal margin, and that the lateral wall of the calcaneus and the body of the calcaneus were separated at the Gissane Angle, followed by an anterolateral fracture, a compression fracture, or a tongue-type fracture of the calcaneus. These findings were obtained through direct observation of the experiment. Biomechanics have been proposed as the basis for managing intra-articular calcaneal fractures (Lowery and Calhoun 1996; Lewis 1999; Rammelt and Zwipp 2004), but the stress changes associated with different types of calcaneal fractures were not yet fully understood.