Abstract
The insertional location of the Achilles tendon traditionally has been thought to
be on the superior aspect of the calcaneus. This is based on descriptions and illustrations
in anatomical textbooks. Our study is a digital magnetic resonance imaging (MRI) examination
of the insertional location of the Achilles tendon in 69 subjects, 12 to 40 years
of age. A midsagittal slice of the ankle was used to identify the most distal insertional
location of the Achilles tendon on the posterior aspect of the calcaneus. The superior
and inferior margins of the posterior aspect of the calcaneus were measured and the
Achilles tendon insertion was calculated as a percentage of the total length of the
posterior aspect of the calcaneus. Our results revealed that there is a statistically
significant difference in the insertional location as related to age. Additionally,
there is a statistically significant proximal migration (0.63%) of the insertional
location with each advancing year. Based on our results, it appears that there is
an inaccurate depiction in the anatomical literature, which may necessitate a change
in the approach to pathologic conditions associated with the Achilles tendon.
Keywords
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© 2011 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
