An anatomic study of the anterior superior process of the os calcis and its clinical application.

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 relationship 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.