Insertional patterns of the Achilles tendon at the calcaneus: a cadaveric study in the Korean population

This study aimed to investigate the insertional patterns of the Achilles tendon at the calcaneus in Korean cadaveric lower limbs and to evaluate whether morphometric characteristics differ according to insertional pattern.

Fifty-five Korean cadavers (110 lower limbs) were dissected. Nine lower limbs with severe deformities were excluded, and 101 lower limbs were included in the final analysis. After separation of the tendon components of the triceps surae, insertional patterns were classified according to the criteria proposed by Edama et al. Tendon length, width, and thickness were measured at predefined reference points.

Three insertional patterns were identified. Type 2 was the most common pattern (55.4%), followed by Type 1 (22.8%) and Type 3 (21.8%). Tendon width and thickness differed significantly according to measurement level (p < 0.001), with the greatest values observed at the calcaneal insertion. However, no significant differences in tendon length, width, or thickness were identified according to insertional pattern.

Type 2 was the predominant insertional pattern of the Achilles tendon in Korean cadaveric lower limbs. Although morphometric characteristics varied along the course of the tendon, they were not significantly associated with insertional patterns. These findings provide baseline anatomical data regarding insertional variation and morphometric characteristics of the Achilles tendon.