Morphometric evaluation of human tendocalcaneus: a cadaveric study of south indian male population

Abstract

SummaryIntroduction: Tendocalcaneus or Achilles tendon is formed by the fusion of the tendons of gastrocnemius and soleus muscles. Normal morphometric measurements of tendo-calcaneus serves an important landmark in its anthropometric evaluation and biomechanical characteristics. Hence the objective of this study was to provide detailed morphometric profile of tendocalcaneus in south indian cadaveric male population. Materials and method: A total of 64 dissected adult limbs was studied. Out of the 64 limbs: 37 belonged to right side while 27 were of the left side. These limbs were dissected to expose the extent of tendocalcaneus. Total length, proximal width and proximal circumference of the tendon, distal width and distal circumference of the tendon was measured. Results were tabulated and correlated using SPSS. Results: Tendon length, width and circumference showed no statistically significant differences between the right and left side. However significant correlation was observed between proximal width and distal widths, proximal circumference and distal circumference, proximal width and proximal circumference and distal width and distal circumference of the tendon. Conclusion: This cadaveric morphometric study of tendo-calcaneus would be very helpful to sports medicine physicians for diagnosis and treatment of tendo Achilles overuse injuries and tendinopathy. Level of evidence: IV.

Morphometric profile of tendocalcaneus of South Africans of European ancestry using a cadaveric approach

“…With the knee in full extension and the foot in a dorsiflexed position (approximately 90°), modified measurements ( Figure 1) previously described by Kumar et al [27] were taken on each limb. Soft tissue within the area of the calcaneus and deep to the TC was cleared until the superior aspect of the calcaneus was visible (Figure 1c).…”

“…Soft tissue within the area of the calcaneus and deep to the TC was cleared until the superior aspect of the calcaneus was visible (Figure 1c). Similar to Liem et al [32], Ebeling et al [33] and Kumar et al [27], the superior aspect of the calcaneal tuberosity was used as the reference point from which all measurements were taken in order to reduce variability in the measurements. Also for repeatability, the distal width and circumference ( Figure 1b) were measured 2 cm from the reference point [32,33] while the proximal width was determined at the lowest level of the musculotendinous junction of the gastrocnemius [24,34,35].…”

“…Also for repeatability, the distal width and circumference ( Figure 1b) were measured 2 cm from the reference point [32,33] while the proximal width was determined at the lowest level of the musculotendinous junction of the gastrocnemius [24,34,35]. Due to ease of access, visibility and without cutting the TC that may compromise measuring its actual length, the medial and lateral lengths of the tendon (Figure 1a) were considered to be the actual length of the TC which is a slight modification to the measurements by Kumar et al [27]. This modification was used because there is a significant variation to the extent or level at which the gastrocnemius and the soleus muscles contribute to the formation of the TC due to the nonconstant orientation of the tendon fibrils [2,3,36].…”

“…The propensity of TC to damage and the subsequent surgical repair or management makes it crucial to understand its morphometry in different population groups. Only two studies are available on the morphometry of tendocalcaneus using a cadaveric approach and both studies utilized cadavers of Indian population [27,28]. Data that closely match the TC dimensions in the living in different population groups will be of benefit to surgical repair and management of tendinopathy.…”

“…The present study assessed the TC morphometry of South Africans of European ancestry using a cadaveric approach. Cadavers were utilized as they provide a realistic measurement and a better morphological description in a 3-D [27,29] compared to a highlysubjective 2-D ultrasound scans [30]. According to Thoirs and Childs [30], image acquisition using ultrasound is identified as the major contributor to measurement errors of the TC.…”