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JOURNAL OF
THE ANATOMICAL SOCIETY OF INDIA

Vol. 49, No. 1, June, 2000


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In this issue :

Editorial
Dr. Patnaik. V.V. Gopichand

A Study of Histology of Human Ductus Arteriosus-Before and After Birth
Baig Mirza Mujahid and Gaikwad P.G. Department of Anatomy, Dr. V.M. Medical College, Solapur. INDIA

Patterns of Talar Articular Facets of Egyptian Calcanei
Saadeh F.A.1 Fuad A.H.,2 Mahmoud S.M.I.,2 Marwan E.E.1 1Department of Human Morphology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon 2Department of Anatomy, University of Alexandria, Alexandria, Egypt Address for Correspondence

Anteversion In Adult Indian Femora
Nagar M, Bhardwaj R., Prakash R. Department of Anatomy University College of Medical Sciences, Shahdara, Delhi-110095 India

Radial and Ulnar Deviation at the Wrist in Young Adult Females
Kakar S. and Kumar Dinesh Department of Anatomy, Lady Hardinge Medical College, New Delhi ? 110 001 INDIA.

Sexing Of The Femora
Leelavathy N, Rajangam S, Janakiram S., Thomas IM, Department of Anatomy, St. John�fs Medical College, Bangalore ? 34 INDIA.

Development of Secondary Sex Characters in Punjabi Jat-Sikh Boys.
Singh Z. Department of Anatomy, G.G.S. Medical College, Faridkot, Punjab, INDIA.

A Comparative Study of Cervical Sympathetic Chain
Kalsey G.1, Mukherjee R.N.2 and Patnaik V.V.G.1 Department of Anatomy,1 Government Medical College Amritsar Punjab, 2Government Dental College Sunder Nagar, (H.P.), INDIA.

Role of Phreno-Esophageal Membrane And Mucosal Flaps in the Functioning of the Gastroesophageal Junction Morphologic And Microanatomic Study In Mammals Including Man.
Patnaik V.V.G. and *Mukerjee R.N. Department of Anatomy, Govt. Medical College, Amritsar (Punjab) and * Govt. Dental College, Sundernagar (H.P.) INDIA.

Effect of Female Oral Contraceptives On Human Chromosomes And Its Role In Behavioural Changes In offsprings
Kumar Keshaw, Department of Anatomy, Institute of Medical Sciences B.H.U., Varanasi, India.

Teratogenic Effects of Intra-amniotic Vitamin A on Rat Fetus
Mohanty C, Singh G., Department of Anatomy, Institute of Medical Sciences, B.H.U. Varanasi. (U.P.), INDIA.

Teratogenicity of Acrolein in Rats
Mohanty C., Singh G., Das B.K.1, Saxena A.K. Department of Anatomy & 1Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.

Bronchopulmonary Changes After Repeated Exposure To Cold Restraint Stress In Rats.
Bharihoke V., *Gupta M. and Gohil H. Department of Anatomy, University College of Medical Sciences and GTB Hospital, Delhi-110095. INDIA. *Department of Anatomy PGIMER Chandigarh.

Fatal anaphylactic shock due to novaglin injection: A case report.
Sahni Daisy, Jit Indar. Department of Anatomy, Postgraduate Institute of Medical Education & Research, Chandigarh.

Anomalous Course of Radial Artery And A Variant of Deep Palmar Arch-A Case Report
Patnaik V.V. Gopichand, Kalsey G. Singla Rajan K. Department of Anatomy, Government Medical College, Amritsar. Punjab, INDIA.

Penile Agenesis : A Case Report
Singh P, 1Singh R.J., Sood V, Sapra A. Department of Anatomy and 1Surgery, Dayanand Medical College and Hospital, Ludhiana. Punjab INDIA.

Rare Cutaneous Branches of Transverse Cervical Artery : A Case Report
Koshy S, Vettivel S.K. Department of Anatomy, Christian Medical College, Vellore, India.

Variations of Superficial Veins of Head & Neck
Yadav S, Ghosh S.K., Anand C. Department of Anatomy, Dr. R.P. Govt. Medical College, Kangra at Tanda-176601 (H.P.) INDIA.

Superficial Palmar Arch Duplication-A Case Report
Patnaik V.V. Gopichand, Kalsey G., Singla Rajan K. Departmet of Anatomy, Govt. Medical Collage, Amritsar, Punjab INDIA.

Missing Caecum-A Case Report
Kaushal S., Batra A.P.S., Kaur M. 1Department of Anatomy, Govt. Medical College, Patiala.

Surgical Incisions - Their Anatomical Basis Part 1 - Head And Neck
Patnaik V.V.G.*, Singla R.K.* and Bala Sanjus Department of Anatomy, *Govt. Medical College, Amritsar (Punjab) and sGovt. Dental College, Amritsar (Pb.) INDIA.

Applied Anatomy of Fascial Spaces In Head and Neck.
Singh T.P., Bala Sanju, 1Kalsey G., 1Singla Rajan K. Department of oral & Maxillofacial Surgery, Pb. Govt. Dental College, Amritsar. 1Department of Anatomy, Government Medical College, Amritsar. Punjab INDIA.


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J.Anat.Soc.India 49(1) 6-8 (2000)
Patterns of Talar Articular Facets of Egyptian Calcanei

Saadeh F.A.1 Fuad A.H.,2 Mahmoud S.M.I.,2 Marwan E.E.1

1Department of Human Morphology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon 2Department of Anatomy, University of Alexandria, Alexandria, Egypt Address for Correspondence

Abstract : The patterns of articulating facets between the talus and calcaneus have been studied in various population groups. The body of the talus articulates in a regular manner with the posterior facet of the calcaneus, while the head articulates with facet(s) on the anterior third of the calcaneus variously described and classified causing difficulties in interpretation. In this study, a larger sample of adult Egyptian calcanei was studied morphometrically. Four distinct facetal patterns were identified. Pattern type I showed continuous middle and anterior facets with a frequency of 63.2%; type II showed separate middle and anterior facets (30.3%) but with subtypes A, B, and C based on degree of separation ranging from less than five millimeters to greater than ten. In type III (4.4%) the anterior facet was absent, while in type IV (2.0%) the posterior, middle, and anterior facets were confluent.

Our pattern types occured with different frequencies than in a previous study of Egyptian calcanei (El-Eishi, 1974) where type IV was not observed. There is a concordance between the results of this study and others done on African and Indian population groups. In Europeans, however, type II, and not type I, is the dominant pattern, again with type IV not observed. Further studies on other population groups are indicated using larger sample size and quantitative parameters to make comparative studies more meaningful.

Keywords : calcaneus; talus; facetal pattern; talo calcanial articulation

Introduction

The calcaneus is the longest and largest of the tarsal bones. It articulates with the overlying talus to form the talocalcanean joint which together with the talocalcaneo-navicular joint are clinically referred to as the subtalar joint (Moore, 1992) where the important movements of inversion and eversion of the foot occur. The middle third of the superior surface of the calcaneus carries the posterior talar facet for articulation with the body of the talus. While a consensus exists in the anatomic literature about the morphology of the posterior facet, there are divergent descriptions of the anterior facet. In the anterior third of the calcaneus, distal and medial to the sulcus calcanei, an articular area covers the sustentaculum tali. This facet articulates with the head of the talus, and may be divided in about half the cases by a non-articular zone creating middle and anterior talar facets the incidence of which varies with race and sex (Williams et al 1995).Using parameters such as degree of separation, fusion, and shape, several workers have described types and preponderance of articular facets on the anterior third of the calcaneus in certain population groups like African, Indian, British, Egyptian, and Spanish (Bunning and Barnett, 1963, 1965; El-Eishi, 1974; Gupta et al., 1977; Forriol campos and Gomez Pellico, 1989). Important race-related differences have emerged that seem to be genetically determined, possibly.

The aim of the present work was to study a larger Egyptian sample than previously used (El-Eishi, 1974) and to introduce quantitative parameters in the description of the talar articular facets of the calacaneus to establish the basis for future comparative studies.

Materials and Methods

For this study, a total of 300 right and left dry calcanei were used. All bones came from adult Egyptian subjects of both sexes. In almost all previous works, male and female calcanei had been grouped together. As far as it could be ascertained, the specimens were free of pathological changes or anomalies. Patterns of talar articular facets were observed under 5X magnification. Facet separation was measured with a sliding reading caliper accurate to 0.05 mm (rounded to 0.1 mm) while facet area was measured with a Keuffel & Esser compensating polar planimeter accurate to 0.01 cm2. All observations and measurements were made twice. A photographic record was kept.

Observations
Patterns of Articular Facets


Fig. 1. Photographs of the superior surface of calcanei: A. left specimen, pattern type 1. B. right specimen, type II, subtype B. C. right specimen, type III. D. right specimen, type IV (all articular boundaries have been digitally enhanced).

Based on our morphometric study of articular facets on the superior surface of the 300 calcanei, four distinct facet patterns can be identified (Table 1). Type I pattern occured with the highest frequency and presented a single facet resulting from the confluence of the middle and anterior facets (Fig. 1A). Because of the variable shape of such a confluence, articular surface area was measured and subsequently done for all types. In type II, the middle facet (on the sustentaculum) and the anterior facet were distinct (Fig. 1B) with a variable degree of separation. Based on this finding, three subtypes were designated: subtype A occured with a frequency of 20.3% of the total sample with moderate separation (5-10 mm). Subtypes B (6.7%) and C (3.4%) showed narrow (<5 mm) and wide
(> 10 mm) separation, respectively. In type III (Fig. 1C) a single facet is present limited to the sustentaculum tali. Type IV (Fig. 1D) was the least frequent with a single extended facet representing the confluence of the posterior, middle and anterior facets. The posterior talar articular facet was present in all calcanei studied.

Articular Surface Areas

The mean surface area of the articular facets was recorded for each of the four facet pattern types and variance assessed (Table 1).

Table 1. Patterns, Frequencies, and Measurements of Articular Facets on Superier Surgace of Calcanues

Pattern type 

n /% frequency

Mean Range (cm2)

surface area (cm2)

I Middle & anterior facets confluent

189/63.0

2.69�}1.30

1.13?6.63

II Middle & anterior facets distinct (the 3 subtypespooled)* 091/30.3

 3.03�}1.30

 0.30?4.00

III Anterior facet absent

014/04.7

1.77�}0.16

 0.55?2.88

IV Posterior, middle & anterior facets confluent

006/02.0 

8.50�}1.20

4.10?10.10

*See description of subtypes A, B and C under OBSERVATIONS.

Discussion

The results of the present study of the talar articular facets of 300 Egyptian calcanei are shown in Table 1. By using a 50% larger sample than in a previous study (El-Eishi, 1974), we could divide the various calcanei into four different pattern types rather than three, according to the morphology of the facets. In our study, type I (confluent middle and anterior facets) occured with a 14% greater frequency than in El-Eishi�fs study, while type IV (confluent posterior, middle and anterior facets) had no counterpart. In the present study, type II (distinct middle and anterior facets) occured with a frequency of 30% versus 40%, with important differences in subtype frequencies. Moderate facet separation was the most frequent subtype in the present study, with wide separation the least. In El-Eishi�fs series, the situation was almost the opposite with narrow separation the most frequent (16%), moderate separation the least (10%), and wide separation (14%) in between. Measurements of mean articular surface area as done in this study (Table 1) were not performed on El-Eishi�fs sample.

It is interesting to note that the mean articular area of confluent middle and anterior facets (type I) is smaller than the sum of the middle and the anterior facets (type II). It seems that confluence arises from two relatively small contiguous articular facets uniting into a single structure.

A survey of previous studies done on the talar articular facets of the calcaneus indicates that the incidence of facet pattern type is related to race. Since these racial differences were also observed in fetal series (Bunning and Barnett, 1965), these are thought to be genetically determined with no tenable functional explanation. These same authors state that type II pattern predominates in Europeans (British). Type II pattern also accounts for almost half the cases in the Spanish (Forriol Campos and Gomez Pellico, 1989). Type I calcaneal pattern has been found to be the dominant pattern in Africans (Nigerian, Sudanese) by Bunning and Barnett (1965, 1963) and in Indians (Gupta et al., 1977; Bunning and Barnett, 1965, 1963). There is a strong correspondence between our Egyptian sample and those for Africans and Indians with type I being the most frequent by far (63%), and type II in second

place (30%). In the other Egyptian study (El-Eishi, 1974) the two types scored 49% and 40%, respectively, with type III a distant third. These results may reflect differences in sample size. As in this study, type IV (confluent posterior, middle and anterior facets) is the rarest except in the Veddah (Ceylonese) group (Bunning and Barnett, 1965). On the other hand, type IV was not present in the Egyptian study (El-Eishi, 1974) or in the Spanish (Forriol Campos and Gomez Pellico, 1989). The results of this study underline the importance of using larger sample size in studying the morphology of the talar facets of the calcaneus. Meaningful comparative studies require a uniform system in the morphometric studies of the calcanei of the various population groups.

References

1. Bunning, P.S.C. & Barnett, C.H. (1965): A comparison of adult and foetal talocalcaneal articulations; Journal of Anatomy 99(1):71-76.
2. Bunning, P.S.C. & Barnett, C.H. (1963): Variations in the talocalcaneal articulations. Journal of Anatomy 97(5):643.
3. El-Eishi, H. (1974): Variations in the talar articular facets in Egyptian calcanei. Acta Anatomica (89):134-139.
4. Forroil Campos, F. & Gomez Pellico, L. (1989): Talar articular facets (facies articulares talares) in human calcanei, Acta Anatomica 134:124-127.
5. Gupta, S.C., Gupta, C.D., & Arora, A.K. (1977): Patterns of talar articular facets in Indian calcanei. Journal of Anatomy 124(3):651-655.

6.

Moore, K.L. Clinically oriented anatomy. 3rd Ed. Williams & Wilkins. Baltimore : 490-491. (1992)

7. Williams, P.L. et al : Gray�fs anatomy In : Skeletal System. 38th Edn, Soames, R.W. Ed, Churchill Livingstone, New York, London : 715 (1995)



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