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Calcaneal Body

corpus calcanei

The calcaneal body is the largest tarsal bone, forming the heel. It contains two weight-bearing facets (middle and posterior subtalar facets) on its superior surface, the insertion for the Achilles tendon posteriorly, and the plantar fascia origin at the medial calcaneal tuberosity inferiorly. The crucial angle (Bohler's angle, normally 20-40 degrees) and the critical angle of Gissane reflect the height of the posterior facet relative to the body and are measured on lateral radiograph to grade fracture severity.

Region: Foot & Ankle

Clinical Relevance

Clinical Notes

Calcaneal fractures are the most common tarsal fracture (60%), typically from axial loading (fall from height). Sanders CT classification (I-IV) based on the number of posterior facet fragments guides treatment: Type I-II fractures may be treated operatively (ORIF for Sanders II in young active patients) or non-operatively; Type III-IV comminuted fractures have limited reconstruction options and may require primary subtalar fusion. The sural nerve and peroneal tendons are at risk in extensile lateral approach ORIF. The Essex-Lopresti mechanism produces tongue-type or joint-depression type fractures based on the direction of the primary fracture line.

Pathology

Common Injuries & Conditions

Sanders Type III Calcaneal Fracture with Posterior Facet Comminution

Axial loading calcaneal fracture with three posterior facet fragments (Sanders III) produces severe flattening of Bohler's angle, widening of the calcaneus, and impingement of the peroneal tendons; ORIF through an extensile lateral approach restores posterior facet articular alignment and calcaneal height and width; subtalar arthrodesis is performed if reconstruction is not possible.