Chinese Journal of Tissue Engineering Research ›› 2020, Vol. 24 ›› Issue (18): 2906-2910.doi: 10.3969/j.issn.2095-4344.2587

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X-ray evaluation of the location and etiology of calcaneal spurs 

Wu Kai, Liao Liqing, Li Yikai    

  1. College of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong Province, China
  • Received:2019-07-20 Revised:2019-07-26 Accepted:2019-10-26 Online:2020-06-28 Published:2020-04-03
  • Contact: Li Yikai, MD, Chief physician, College of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong Province, China
  • About author:Wu Kai, Master candidate, College of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong Province, China

Abstract:

BACKGROUND: A large number of studies in and outside China have confirmed that the occurrence of calcaneus spur is related to plantar fasciitis, osteoarthritis and other diseases. For the etiology of calcaneus spur, two hypotheses have been proposed, which are “vertical compression” and “vertical traction”, but they have not been confirmed.

OBJECTIVE: To analyze morphology and location of calcaneal spurs so as to analyze the etiology of calcaneal spurs.

METHODS: Totally 831 complete dry calcaneal specimens and 222 cases of X-ray films were randomly selected, including 33 cases aged 18-30 years, 97 cases aged 31-50 years, 83 cases aged 51-70 years, and 9 cases aged 71-90 years. Morphology and location of calcaneal spurs were observed. The length and width of the calcaneal spurs were measured directly by vernier caliper. The length of the calcaneal spurs was measured by using the related software in the calcaneus lateral X-ray film. The implementation of the research program was in line with the ethical requirements of Southern Medical University. The calcaneal specimens used in the experiment were provided by the Department of Anatomy of Southern Medical University and were donated voluntarily by the donors.

RESULTS AND CONCLUSION: (1) There were 142 specimens of calcaneal spur in the calcaneal specimens and 82 cases of calcaneal spurs in the lateral X-ray films. The highest point of 88.1% of achilles tendon spurs was in lateral edge of the calcaneus, and the plantar spurs were all located in the medial nodule of the calcaneus. (2) X-ray films showed that the average age of the spur-free population was (42.9±14.2) years, and the average age of the population with spurs was (54.0±13.4) years. The average age of patients with Achilles tendon spur was (42.3±14.9) years. The difference between spur-free population and population with spurs was statistically significant (P < 0.05). The difference between the average age of the spur-free population and the individuals with Achilles tendon spurs was not statistically significant (P > 0.05). (3) Calcaneal specimen showed that the shape of Achilles tendon spur was vertical ridge, and the plantar spur was lamellar. (4) Results indicated that the incidence rate of spurs in X-ray films was significantly higher than that in specimens. The calcaneal spur was mainly in lateral edge of the Achilles tendon attachment, and the plantar spurs were all located in the medial nodule of the calcaneus. The incidence of calcaneal spur is different in different age groups, suggesting that the Achilles tendon spur may be caused by longitudinal traction and the plantar spur may be caused by vertical compression.

Key words:

calcaneus, spur, Achilles tendon, morphology, location, etiology, vertical compression, longitudinal traction

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