Classification by degree of twisted structure of the fetal Achilles tendon.

BACKGROUND The purpose of this study was to classify the twisted structure of the fetal Achilles tendon. METHODS The study was conducted using 30 legs from 15 Japanese fetuses (mean weight, 1764.6 ± 616.9 g; mean crown-rump length, 283.5 ± 38.7 mm; 16 males, 14 females). According to attachment to the deep layer of the calcaneal tuberosity, cases showing only soleus attachment were classified as least twist (Type I), cases showing both lateral head of the gastrocnemius and soleus were classified as moderate twist (Type II), and cases with only lateral head of the gastrocnemius were classified as extreme twist (Type III). RESULTS Viewing the Achilles tendon from cranially shows a structure twisted counterclockwise on the right side and clockwise on the left. The Achilles tendon was Type I in 4 legs (13%), Type II in 23 legs (77%), and Type III in 3 legs (10%). CONCLUSIONS The twisted structure of the Achilles tendon can be classified as early as the second trimester and is similar to that seen in adults.