Calcaneus

The calcaneus, also referred to as the calcaneum, is the largest tarsal bone and the major bone in the hindfoot. It articulates with the talus superiorly and the cuboid anteriorly and shares a joint space with the talonavicular joint, appropriately called the talocalcaneonavicular joint. The calcaneus transfers most of the body weight from the lower limb to the ground.

The calcaneus is an irregular, roughly box-shaped bone sitting below the talus, and its anterior aspect is inclined cranially. It projects posteriorly to form the core of the heel.

The dorsal part of the calcaneus is circular and provides the attachment site for the calcaneal tendon (Achilles tendon) posteriorly at the calcaneal notch and facilitates weight bearing inferiorly at the calcaneal tuberosity. The plantar surface of the calcaneal tuberosity contains a medial and lateral process and at its most anterior projection is the calcaneal tubercle, where the short plantar ligament attaches.

On the otherwise fairly smooth lateral aspect of the calcaneus is the fibular trochlea (peroneal tubercle), where the tendons of the fibularis brevis and longus muscles pass.

Protruding anteromedially is the sustentaculum tali which supports the anteromedial part of the talus. At its inferior aspect is a groove accommodating the flexor hallucis longus tendon. Superiorly is a cartilage covered facet for the middle portion of the subtalar joint, which is inclined anteriorly.

The anterior and posterior facets of the talocalcaneal joint are on the superior surface of the calcaneus, of which the posterior facet is the largest. Between these two facets runs a fairly deep sulcus, the calcaneal sulcus, which together with the opposing talar sulcus forms the tarsal sinus (sinus tarsi). The posterior facet is inclined anteriorly.

Attachments
Musculotendinous
Ligamentous
  • lateral: lateral collateral ligament of the ankle joint
  • inferior: short plantar ligament (at calcaneal tubercle)
  • superior: tarsal sinus ligaments, including:
    • cervical ligament
    • talocalcaneal interosseous ligament,
    • lateral, intermediate, and medial roots of the inferior extensor retinaculum
  • anterior: plantar calcaneonavicular ligament (the spring ligament)
Articulations

Superiorly, the calcaneus articulates with the talus at the talocalcaneal joint, also known as the (anatomic) subtalar joint, making contact at anterior, middle and posterior facets.

The anterior part of the talocalcaneal joint and the talonavicular joint are collectively known as the talocalcaneonavicular joint, and may share the same joint space. 

Anteriorly, the calcaneus articulates with the cuboid (calcaneocuboid joint) bones. 

Relations
  • superior: talocalcaneal joint, talus
  • inferior: fat pad of calcaneus, long plantar ligament, short plantar ligament, plantar aponeurosis, quadratus plantae, flexor digitorum brevis
  • anterior: calcaneocuboid joint, cuboid bone
  • posterior: Achilles tendon, posterior talocalcaneal ligament
  • medial: tendon of flexor hallucis longus, calcaneal branches of posterior tibial artery, tibial nerve, tendon of flexor digitorum longus, tendon of tibialis posterior, flexor retinaculum, abductor hallucis, flexor digitorum brevis, spring ligament, deltoid ligament of ankle, medial talocalcaneal ligament
  • lateral: tendon of fibularis brevis, tendon of fibularis longus, superior and inferior fibular retinaculum, calcaneal branches of fibular artery, calcaneofibular ligament, lateral talocalcaneal ligament, abductor digiti minimi, lateral calcaneal branches of sural nerve
  • medial calcaneal arteries (from posterior tibial artery)
  • lateral calcaneal arteries (from fibular artery)
  • posterior calcaneal arterial anastomosis (by above mentioned)
  • medial and lateral plantar arteries
  • artery of the tarsal sinus and tarsal canal, branches of lateral tarsal artery

Branches of:

  • tibial nerve
  • sural nerve
  • deep fibular nerve
Lower limb anatomy
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Article information

rID: 31905
Section: Anatomy
Synonyms or Alternate Spellings:
  • calcaneum
  • os calcaneus

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    Figure 3: lateral anatomy
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    Figure 4: dorsal anatomy
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