Adult Human Tali Calcaneal Articular Facet Patterns of North-West Uttar Pradesh (India) and its Clinical Implication with Fracture

Introduction: Aim of the present study is to find out anatomical presence and percentage of incidence of various patterns of calcaneal articular facets in north-west Uttar Pradesh (India). The prior acquaintance with the anatomical set up of talus and its various articulations holds significance not only in delineating the underlying pathology and fracture fixation but also helps in overall treatment of diseases of the talus bone. Materials and Methods: Forty human tali adult dry were procured from the bone sets of the department of anatomy, forensic medicine and 1st year MBBS students. Tali were examined individually and were observed for the types of calcaneal articular facets. They were classified into groups, their anatomical setup and percentages of incidence were studied. Results: In the present study, four patterns of calcaneal articular facets of north-west Uttar-Pradesh adult's tali were observed and classified. Their percentages of incidence was type-1 (40%=16), type-2 (30%=12), type- 3 (20%=08), type-4 (10%=04). In our study, a majority of calcaneal articular facets of tali shows the 2-facet configuration (Type-1pattern). These findings were compared with the available literature and we find that different type and different dominance of articular facets of tali for calcaneum were present. Discussion: The present study has revealed that the various types of facets may be due to racial and individual differences and relation of talus and calcaneum with other tarsal bones. This may also be due to gait somato type of the individual and walking habits in plains/ hilly areas. Bruckner in contrast to view of most researchers, argues that the 2-facet configuration (type-1) is more stable than the others types. Severe fractured talus ends up in disruption of articular congruity and/or loss of talar length, alignment, and rotation. Operative treatment to restore hind foot anatomy and mechanics as well as joint congruity requires a detailed knowledge of talar facets and of the subtalar joint. Even small residual-fracture displacement can result in a significant compromise of subtalar, ankle, or talonavicular joint functions. The prior knowledge of tali calcaneal articular facets may be used to place an inter-fragmentary lag screw down the neck of the talus to avoid the sinus tarsi inferiorly, so that the arterial supply of talus in sinus tarsi may not be compromised.