Internal architecture of calcaneus: correlations with mechanics and pathoanatomy of calcaneal fractures

Available studies on internal architecture of the calcaneus are cursory and contradictory. Present study focused on elaborate descriptions of the different trabecular groups and their correlation with the fractures of this bone. To study the internal architecture, 50 dry adult human calcanei were sectioned in various planes and grossly dissected. Six different groups (A-F) of lamellae were identified. Based on the observations of trabecular architecture, potential weak areas in this bone were identified. The predicted weak zones correlate well with the fracture lines described in the calcaneus and provide anatomical basis for their occurrence. This study underscores the major influence of the internal architecture of the calcaneus in predicting the fracture lines. The findings can be utilized to classify fractures of calcaneus, which has been a topic of ongoing debate. Knowledge of weak zones will aid clinicians to improve the techniques of internal fixation.