Sabry F F, Ebraheim N A, Mehalik J N, Rezcallah A T
Department of Orthopaedic Surgery Medical College of Ohio, Toledo 43614, USA.
Foot Ankle Int. 2000 Feb;21(2):114-8. doi: 10.1177/107110070002100204.
Fourteen cadaveri specimens were sectioned to analyze the internal architecture of the human calcaneus. We described the arrangement and orientation of trabecular patterns within the calcaneus and made multiple measurements of its cortical thickness.
To characterize the internal architecture of the calcaneus and correlate these findings with well-described patterns of calcaneus fracture in order to better understand the fracture mechanics of this common fracture.
Fourteen dry, frozen, human calcanei were sectioned using a saw. In each the coronal, sagittal and axial planes, we sectioned separate specimens into slices of 0.5 mm thickness. High-resolution radiographic images were taken of the sectioned specimens. The internal trabecular arrays were described and measurements of cortical thickness were recorded. The correlation between these findings and the known pattern of calcaneal fractures was analyzed.
A dominant trabecular pattern running antero-posteriorly along the long axis of the calcaneus was observed. In the posterior tuberosity the trabeculae were arranged parallel to the posterior border. There was an area of sparse or absent mineralization in the anterior part of the calcaneus corresponding to the "neutral triangle" described by Wood and Harty 10, 23. The thickest sites of the calcaneal cortex were the lower pole of the posterior tuberosity, the upper surface at the angle of Gissane, and the lateral surface below the anterior portion of the posterior facet.
The trabecular architecture of the calcaneus is created by applied stress in concordance with Wolff's law. The weakest plane of resistance to stress is parallel to these organized trabeculae or through areas lacking trabeculae. This study demonstrates that the primary and secondary fracture lines commonly encountered in calcaneus fractures correlates with the internal architectural map of the calcaneal trabecular patterns.
对14个尸体标本进行切片，以分析人类跟骨的内部结构。我们描述了跟骨内小梁模式的排列和方向，并对其皮质厚度进行了多次测量。
描述跟骨的内部结构，并将这些发现与已充分描述的跟骨骨折模式相关联，以便更好地理解这种常见骨折的骨折力学。
使用锯子将14个干燥、冷冻的人类跟骨进行切片。在每个跟骨的冠状面、矢状面和轴面，我们将单独的标本切成0.5毫米厚的薄片。对切片后的标本拍摄高分辨率的放射图像。描述内部小梁排列，并记录皮质厚度测量值。分析这些发现与已知跟骨骨折模式之间的相关性。
观察到一种沿跟骨长轴前后走行的主要小梁模式。在后部结节中，小梁与后缘平行排列。在跟骨前部对应于Wood和Harty所描述的“中性三角”的区域，存在矿化稀疏或缺失的情况。跟骨皮质最厚的部位是后部结节的下极、吉桑角处的上表面以及后关节面后部下方的外侧表面。
跟骨的小梁结构是由与沃尔夫定律一致的施加应力形成的。抵抗应力的最薄弱平面与这些有组织的小梁平行或穿过缺乏小梁的区域。本研究表明，跟骨骨折中常见的主要和次要骨折线与跟骨小梁模式的内部结构图谱相关。
