https://www.ijmhr.org/ijar.htm editor_anatomy@ijmhr.org
ISSN:       2321-4281 (E) 2321-8967 (P)

IJAR.2019.165

DOWNLOAD PDF
Table of Contents

Type of Article:  Original Research

Volume 7; Issue 2.2 (May 2019)

Page No.: 6550-6555

DOI: https://dx.doi.org/10.16965/ijar.2019.165

MORPHOMETRIC ANALYSIS OF TENDOACHILLES TENDON WITH ITS CLINICAL IMPLICATIONS

Manju Singhal *1, Nisha Parmar 2, Deepak Singhal 3.

*1 Associate professor, Department of Anatomy, Surat Municipal Institute of Medical Education and Research (SMIMER), Surat, Gujarat, India.

2 Tutor, Department of Anatomy, Surat Municipal Institute of Medical Education and Research (SMIMER), Surat, Gujarat, India.

3 Tutor, Department of FMT, Surat Municipal Institute of Medical Education and Research (SMIMER), Surat, Gujarat, India.

Address for Correspondence:  Dr. Manju Singhal, MBBS, MD (Anatomy), 48, Sumangal Prabhat society, opposite Kapadia health club, Bhatar Road, Surat-395001, Gujarat, India. Mobile: 9427544466

E-Mail: manjudeepaksinghal@gmail.com

ABSTRACT:

Background: Tendoachilles tendon, the strongest and thickest tendon of the body, is formed by tendons of soleus and gastrocnemius begins near the middle of the back of leg and is inserted to the midpoint of the posterior surface of the calcaneum. Normal morphometric measurements of Achilles tendon serve as an important landmark in its anthropometric evaluation and biomechanical attribute. The morphological changes in the tendon size provide important health information for the management of various clinical conditions related to Achilles tendons like simple tendinopathy or acute ruptures of it etc.

Aim: The current study aimed at finding out the detailed morphometric measurements of the Achilles tendon which can be of substantial use to clinicians for determining any pathological conditions associated with tendoachilles.

Materials and Methods: Total 108 lower limbs from 54 donated embalmed cadavers (31 males & 23 females) of age between 55 to 85 years were procured for dissection. The study was carried out in the department of Anatomy SMIMER Surat.

Results: Present cadaveric study found that the length of tendoachilles was significantly high in male than in female and no statistically significant difference in length of tendoachilles between right and left side were noted. The width of the tendoachilles at origin between the right and left side tendons was statistically significant.

Discussion: We found that the length of Tendoachilles was significantly high in male than in female and also width of the tendoachilles at origin was more on right side. Being a frequent site for rupture, degenerative change and inflammation, knowledge pertaining to normal morphometric measurements of Achilles tendon is imperative before determining any pathological variations associated with the tendon and opens the management options to orthopedic surgeons, podiatrist, sports physicians and physiotherapists.

Key Words: Tendoachilles tendon, Tendocalcaneus, Morphometric analysis, Tendinopathy.

REFERENCES

  1. Reinherz RP, Zawada SJ, Sheldon DP. Recognizing unusual tendon pathology at the ankle. J Foot Surg 1986;25:278–283.
  2. Standring S, editor. Gray’s Anatomy. 40th ed. Edinburgh: Churchill Livingstone; 2010. pp. 1451.
  3. Standring S, editor. Gray’s Anatomy. 40th ed. Edinburgh: Churchill Livingstone; 2010. pp. 1420.
  4. Chaurasia B.D, Human Anatomy, Lower limb and Abdomen. 1st ed. CBS Publisher; 1988.pp.1.
  5. Bramble DM, Lieberman DE. Endurance running and the evolution of Homo. Nature 2004;432:345-352
  6. White JW. Torsion of the Achilles tendon: Its surgical significance. Arch Surg 1943; 46:784-787.
  7. Cummins EJ, Anson BJ, Carr BW, Wright RR, Hauser EDW. The structure of calcaneal tendon ( of Achilles) in relation to orthopedic surgery. Surg. Gynecol Obstet 1946; 83:107-116.
  8. Maffulli, Nicola, Michael Benjamin, P. Theobald, D. Suzuki, and H. Toumi. The Anatomy of the Achilles Tendon – The Achilles Tendon.1st 2007; 5-15.
  9. Ker RF, Bennett MB, Bibby SR, Kester RC, Alexander RM. The spring in the arch of the human foot.Nature1987;325:147-149.
  10. Mazzone, M.E. and T. Mccue. Common conditions of the Achilles Tendon: American family physician, 2002;65:1908-1910.
  11. Maffulli N, Ewen SW, Waterston SW, Reaper J, Barrass V. Tenocytes from ruptured and tendinopathic achilles tendons produce greater quantities of type III collagen than tenocytes from normal Achilles tendons. An in vitro model of human tendon healing. Am J Sports Med. 2000;28:499-505.
  12. Whittaker P, Canham PB. Demonstration of quantitative fabric analysis of tendon collagen using two-dimensional polarized light microscopy. Matrix. 1991;11:56-62.
  13. Strocchi R, De Pasquale V, Guizzardi S, Govoni P, Alberto Facchini, Mario Raspanti, Mauro Girolami, Sandro Giannini. Human Achilles tendon: Morphological and Morphometric Variations as a Function of Age. Foot & Ankle International. 1991;12(2);100-104.
  14. Jarvinen TA, Jarvinen TL, Kannus P, Jozsa L, Jarvinen M. Collagen fibers of the spontaneously ruptured human tendons display decreased thickness and crimp angle. J Orthop Res. 2004;22:1303-1309.
  15. Koivunen-Niemela T, Parkkola K. Anatomy of the Achilles tendon (tendo calcaneus) with respect to tendon thickness measurements. Surg Radiol Anat. 1995;17:263-268.
  16. Levangie P, Norkin C. Joint structure and function: a comprehensive analysis. The ankle and foot complex. 5th ed. New Delhi; Jaypee Brothers. 2011;440-482.
  17. Naveen Kumar, Ashwini P Aithal, Satheesha B Nayak, Jyothsna Patil, Abhinitha Padavinangadi, Biswa Bina Ray. Morphometric evaluation of human tendocalcaneus: a cadaveric study of south indian male population. Muscles Ligaments Tendons J. 2017 Jan-Mar; 7(1): 62–68.
  18. Apaydin N, Bozkurt M, Loukas M, Vefali H, Tubbs RS, Esmer AF. Relationships of the sural nerve with the calcaneal tendon: an anatomical study with surgical and clinical implications. Surg Radiol Anat. 2009;31(10):775–780.
  19. Canbolat M, Ozba D, Ozdemir Z, Demirtafl G, fiahin Kafkas A. Effects of physical characteristics, exercise and smoking on morphometry of human Achilles tendon: an ultrasound study. Anatomy. 2015;9(3):128–134.
  20. Balius R, Alomar X, Rodas G, et al. The soleus muscle: MRI, anatomic and histologic findings in cadavers with clinical correlation of strain injury distribution. Skeletal Radiol. 2013;42:521–530.
  21. Egwu OA, Ogbonna CO, Salami E, Eni OE, Besong E, Onwe CC. Normal thickness of the tendo calcaneus (TCT) in an adult Nigerian population: an imaging based normographic study. Br J Med Med Res. 2014;4:2100–2111.
  22. Knobloch K, Kraemer R, Lichtenberg A, et al. Achilles tendon and paratendon microcirculation in midportion and insertional tendinopathy in athletes. Am J Sports Med. 2006;34(1):92–97.
  23. DeMello RAF, Marchiori E, dos Santos AASMD, Torres Neto G. Morphometric evaluation of Achilles tendon by ultrasound. Radiol Bras. 2006;39(3):161-165.
  24. Muraoka T, Muramatsu T, Fukunaga T, Kaneehisa H. Elastic properties of human Achilles tendon are correlated to muscle strength. J Appl Physiol 2005;99:665-9.
  25. Munteanu SE, Barton CJ. Lower limb biomechanics during running in individuals with Achilles tendinopathy: a systematic review. J Foot Ankle Res. 2011;4(1):1–15.
  26. Koivunen-Niemelä T, Parkkola K. Anatomy of the Achilles tendon (tendo calcaneus) with respect to tendon thickness measurements. Surg Radiol Anat. 1995;17:263–268.
  27. Silbernagel KG, Shelley K, Powell S, Varrecchia S. Extended field of view ultrasound imaging to evaluate Achilles tendon length and thickness: a reliability and validity study. Muscles, Ligaments and Tendons Journal. 2016;6(1):104-110.

Cite this article: Manju Singhal, Nisha Parmar, Deepak Singhal. MORPHOMETRIC ANALYSIS OF TENDOACHILLES TENDON WITH ITS CLINICAL IMPLICATIONS. Int J Anat Res 2019;7(2.2):6550-6555. DOI: 10.16965/ijar.2019.165