The functional anatomy of Kager's fat pad in relation to retrocalcaneal problems and other hindfoot disorders

Theobald, Peter ORCID: https://orcid.org/0000-0002-3227-7130, Bydder, G., Dent, Colin Michael, Nokes, Leonard Derek Martin ORCID: https://orcid.org/0000-0002-9504-8028, Pugh, Neil D. ORCID: https://orcid.org/0000-0002-6721-2265 and Benjamin, Michael 2006. The functional anatomy of Kager's fat pad in relation to retrocalcaneal problems and other hindfoot disorders. Journal of anatomy 208 (1) , pp. 91-97. 10.1111/j.1469-7580.2006.00510.x

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Abstract

Kager's fat pad is a mass of adipose tissue occupying Kager's triangle. By means of a combined magnetic resonance imaging, ultrasound, gross anatomical and histological study, we show that it has three regions that are closely related to the sides of the triangle. Thus, it has parts related to the Achilles and flexor hallucis longus (FHL) tendons and a wedge of fat adjacent to the calcaneus. The calcaneal wedge moves into the bursa during plantarflexion, as a consequence of both an upward displacement of the calcaneus relative to the wedge and a downward displacement of the wedge relative to the calcaneus. During dorsiflexion, the bursal wedge is retracted. The movements are promoted by the tapering shape of the bursal wedge and by its deep synovial infolds. Fibrous connections linking the fat to the Achilles tendon anchor and stabilize it proximally and thus contribute to the motility of its tip. We conclude that the three regions of Kager's fat pad have specialized functions: an FHL part which contributes to moving the bursal wedge during plantarflexion, an Achilles part which protects blood vessels entering this tendon, and a bursal wedge which we suggest minimizes pressure changes in the bursa. All three regions contribute to reducing the risk of tendon kinking and each may be implicated in heel pain syndromes.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine Biosciences Engineering
Subjects:	Q Science > QC Physics R Medicine > R Medicine (General) T Technology > TJ Mechanical engineering and machinery
Uncontrolled Keywords:	Achilles tendon ; bursa ; enthesis ; enthesopathy ; Haglund's deformity ; Kager's triangle ; retrocalcaneal bursitis
ISSN:	1469-7580
Last Modified:	17 Oct 2022 09:08
URI:	https://orca.cardiff.ac.uk/id/eprint/2128

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