Anatomical study of calcaneal sustentaculum tali lateral wall projection and its application in fracture internal fixation surgery

doi:10.3877/cma.j.issn.2096-0263.2026.01.008

Abstract

Abstract:

Objective

To determine the projection range and coordinate parameters of the calcaneal sustentaculum tali on the lateral wall of the calcaneus through anatomical study, providing precise parameters for screw insertion position, angle, and length in clinical calcaneal fracture internal fixation surgery to improve surgical accuracy and safety.

Methods

Sixty foot specimens from 30 adult Chinese cadavers collected from January 2021 to December 2021 were selected. A combination of CT three-dimensional reconstruction technology and physical anatomical measurement was used to determine the morphological parameters of the sustentaculum tali and its projection coordinates on the lateral wall of the calcaneus. A coordinate system was established using the Gissane angle apex and posterior joint surface as references, measuring the geometric parameters of the sustentaculum tali projection area, and verifying the clinical application value of the projection area through 2.0mm Kirschner wire simulation of screw insertion pathway.

Results

The mean projection distance of the sustentaculum tali was (34.37±2.61)mm, with a mean projection area length of (20.25±1.80)mm and mean width of (10.19±1.10)mm. The mean anterior inclination angle of the sustentaculum tali was (30.60±4.73)°, and the mean varus angle was (25.29±6.38)°. Physical measurements showed that the projection area of the sustentaculum tali was approximately rectangular, with coordinate parameters highly consistent with CT measurement results (P<0.05). Screw insertion experiments confirmed that screws inserted according to the projection area coordinate parameters could effectively penetrate the sustentaculum tali without causing vascular or neurological injuries.

Conclusion

The projection of the calcaneal sustentaculum tali on the lateral wall of the calcaneus has a relatively fixed anatomical position and geometric morphology. The established coordinate parameter system can provide reliable anatomical basis for clinical calcaneal fracture internal fixation surgery, helping to improve the accuracy and safety of screw insertion and reduce the risk of surgical complications.

Key words: Calcaneus, Sustentaculum tali, Anatomy, Projection, Internal fixation

Pengfei Cao, Yi He, Yin Zhang, Xunan Xu, Chun Jiang, Yong Liu. Anatomical study of calcaneal sustentaculum tali lateral wall projection and its application in fracture internal fixation surgery[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2026, 12(01): 54-58.

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References 20

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组别	例数	年龄（岁）	足长（mm）	足宽（mm）	跟骨长度（mm）	跟骨宽度（mm）	载距突长度（mm）	载距突宽度（mm）
男性	32	52.3±8.7	248.6±12.4	96.3±8.2	78.4±5.3	42.8±3.7	20.1±1.8	10.3±1.2
女性	28	49.8±9.2	231.7±11.8	89.4±7.6	72.6±4.9	39.2±3.4	19.6±1.7	9.8±1.1
t/χ²值		1.142	5.689	3.547	4.632	4.089	1.165	1.756
P值		0.259	<0.001	0.001	<0.001	<0.001	0.249	0.084

组别	例数	年龄（岁）	足长（mm）	足宽（mm）	跟骨长度（mm）	跟骨宽度（mm）	载距突长度（mm）	载距突宽度（mm）
男性	32	52.3±8.7	248.6±12.4	96.3±8.2	78.4±5.3	42.8±3.7	20.1±1.8	10.3±1.2
女性	28	49.8±9.2	231.7±11.8	89.4±7.6	72.6±4.9	39.2±3.4	19.6±1.7	9.8±1.1
t/χ²值		1.142	5.689	3.547	4.632	4.089	1.165	1.756
P值		0.259	<0.001	0.001	<0.001	<0.001	0.249	0.084

测量方式	例数	长度（mm）	宽度（mm）	高度（mm）	前倾角（°）	内翻角（°）
CT测量	60	20.25±1.80	10.19±1.10	8.47±0.92	30.60±4.73	25.29±6.38
实体测量	60	20.08±1.82	10.31±1.19	8.52±0.89	30.21±4.86	25.67±6.28
t值		0.142	-0.349	-0.282	0.352	-0.274
P值		0.887	0.728	0.779	0.726	0.785

测量方式	例数	长度（mm）	宽度（mm）	高度（mm）	前倾角（°）	内翻角（°）
CT测量	60	20.25±1.80	10.19±1.10	8.47±0.92	30.60±4.73	25.29±6.38
实体测量	60	20.08±1.82	10.31±1.19	8.52±0.89	30.21±4.86	25.67±6.28
t值		0.142	-0.349	-0.282	0.352	-0.274
P值		0.887	0.728	0.779	0.726	0.785

参数	测量值（±s）	范围	95% CI	变异系数（CV，%）
投影距离MN（mm）	34.37±2.61	28.40-41.50	33.77-35.13	7.59
投影区长度a（mm）	20.25±1.80	17.70-24.80	19.68-20.58	8.89
投影区宽度b（mm）	10.19±1.10	7.80-13.10	9.94-10.52	10.79
投影区面积（mm²）	205.93±28.47	138.06-323.28	198.59-213.27	13.83
投影角度α（°）	30.60±4.73	21.60-38.80	29.32-31.76	15.46
投影角度β（°）	25.29±6.38	18.20-37.50	23.68-26.98	25.23

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