Böhler's angle

NewsBot · Aug 1, 2012

Members do not see these Ads. Sign Up.
Böhler's angle – What is normal in the uninjured British population?
H. Willmott, J. Stanton, C. Southgate
Foot and Ankle Surgery Volume 18, Issue 3, September 2012, Pages 187–189

Böhler's angle is a radiographic parameter widely used in the detection and assessment of fractures of the os calcis. The normal range in the uninjured British adult population has not previously been established. We analysed 128 lateral radiographs without fracture in order to establish the true value of Böhler's angle. Analysis was performed with respect to age, sex and laterality. Interobserver reliability was also assessed. The mean angle was 36.4° (SD 4.2°, range 24.7–48.9°). The normal range was 28.2–44.5°, which incorporates 95% of subjects. There was no difference with respect to age, sex or laterality. Agreement between independent observers was good (interobserver correlation coefficient = 0.72), although there was disagreement of >5° in 40.9% of cases. Given the wide range of normal values we recommend a comparative radiograph of the contralateral side if the presence of fracture is ambiguous.
Click to expand...

Admin2 · Aug 1, 2012

Related threads:
Other threads tagged with haglunds deformity
Management of Retrocalcaneal Pain
Insertional Achilles Tendinitis and Haglund’s Deformity
Surgery for Retrocalcaneal Bursitis: A Tendon-splitting versus a Lateral Approach
Retro-calcaneal bursae
Retrocalcaneal Pain: Diagnostic ultrasound case study
Haglunds in an elite marathon runner
Reduction of retrocalcaneal bursitis?
Posterior Calcaneal Exostosis

NewsBot · Sep 24, 2013

The Diagnostic Accuracy of Böhler's Angle in Fractures of the Calcaneus.
Isaacs JD, Baba M, Huang P, Symes M, Guzman M, Nandapalan H, Moopanar T, Marchalleck S, Szomor Z.
J Emerg Med. 2013 Sep 17.

BACKGROUND:
Böhler's historical tuber-joint angle of the calcaneus has been used since 1931. Surprisingly, there is a paucity of literature on its use.
OBJECTIVES:
To confirm the normal range for Böhler's angle and determine the angle with the highest accuracy in the diagnosis of calcaneal fractures.
METHODS:
A retrospective cohort study was performed. The study cohort comprised 424 patients spanning a 5-year period from April 2005 to March 2010. Böhler's angle was measured by two independent observers on lateral x-ray study using the digital angle tool from the Picture Archival and Communication System. Data were analyzed using Stata 8 statistical software package.
RESULTS:
The mean Böhler's angle in patients without calcaneal fracture was 29.4°. In this group there was no difference in Böhler's angle between male and female patients, left and right feet, or across age. In those patients with calcaneal fractures, a Böhler's angle below 25° was moderately predictive of calcaneal fracture (sensitivity = 100%, specificity = 82%), an angle below 23° was highly predictive of calcaneal fracture (sensitivity = 100%, specificity = 89%), and an angle below 21° was strongly suggestive of calcaneal fracture (sensitivity = 99%, specificity = 99%). A Böhler's angle of ≤ 20° had the highest diagnostic accuracy.
CONCLUSION:
A Böhler's angle of 20° or less is highly accurate in determining the presence or absence of calcaneal fracture. Böhler's angle serves as a useful screening tool in fracture diagnosis.
Click to expand...

NewsBot · Oct 31, 2017

The physiological range of the Böhler's angle in the adult Croatian population
Marko Šimunović et al
Foot and Ankle Surgery; Article in Press

Highlights
•A decreased value of the Böhler’s angle (< 20 degrees) indicates calcaneal fracture.
•The Böhler’s angle is not related to age, sex, and laterality.
•Its interrater reliability is almost perfect.
Click to expand...

Background
To examine the relationship of the Böhler’s angle with age, sex, and laterality, and to analyze the interrater agreement.

Methods
After 248 digital lateral radiographs of the foot were submitted to exclusion criteria, three raters independently measured the Böhler’s angle on the remaining 130 X-rays in PACS. The variables were analyzed with correlation coefficients, and one-way ANOVA. The repeated measures of ANOVA were computed across age groups (30-39, 40-49, 50-59, and 60-69 years). The interrater agreement was calculated using intraclass correlation coefficient (ICC).

Results
The mean value of the Böhler’s angle was 34 ± 5 degrees (21–46 degrees). It was not related to age (in general [p = 0.057], and across groups [p from 0.107 to 0.122]), sex (p = 0.344; p = 0.342), and laterality (p = 0.618; p = 0.617). The interrater reliability was almost perfect (ICC = 0.94).

Conclusions
The Böhler’s angle was not related to age, sex, and laterality, whereas the interrater agreement was almost perfect.
Click to expand...

NewsBot · Nov 6, 2018

Contribution of a new radiologic calcaneal measurement to the treatment decision tree in Haglund syndrome.
Tourné Y et al
Orthop Traumatol Surg Res. 2018 Oct 31.

INTRODUCTION:
In Haglund syndrome, standard radiologic measurements lack specificity and reliability in assessing etiologic morphologic calcaneal abnormalities. We report a simple X/Y ratio to measure posterior calcaneal length, where X is calcaneal length on lateral weight-bearing view and Y is greater tuberosity length.

OBJECTIVE:
To compare this new parameter against the radiologic gold standard in a group of Haglund patients and a healthy control group.

HYPOTHESIS:
Measuring this ratio significantly distinguishes between Haglund patients and healthy subjects.

MATERIAL AND METHODS:
A retrospective study included 50 Haglund syndrome patients and 30 healthy controls. Standard measurements (Fowler-Philipangle, Chauveaux-Liet angle, Ruch pitch, Heneghan-Pavlov test) and X/Y ratio were calculated twice by 2 independent observers. Intra- and inter-observer correlations were calculated, as were the specificity and sensitivity of the various parameters, with a ROC curve to establish the X/Y threshold.

RESULTS:
All measurements were reproducible on intra- and inter-observer testing. There were no significant inter-group differences in standard measurement specificity or sensitivity. The Haglund group showed significantly lower X/Y ratio (2.07) than controls (2.70; p<0.0001), with a cut-off at 2.5. Threshold sensitivity in confirming Haglund syndrome was 100% (p<0.0001) and specificity 95% (p<0.0001).

DISCUSSION:
This new parameter measures the length of the calcaneus and its greater tuberosity. It is more reliable and reproducible in terms of sensitivity and specificity than standard measurements in Haglund syndrome. The 2.5 ratio threshold can guide surgical decision-making.
Click to expand...

NewsBot · Mar 21, 2019

Bohler Angle and the Crucial Angle of Gissane in Paediatric Population.
Pombo B et al
Clin Med Insights Arthritis Musculoskelet Disord. 2019 Mar 12

Bohler angle and the crucial angle of Gissane are used on the evaluation of calcaneus fractures. However, few authors have described the variation of the angles when the calcaneus is growing. In this study, Bohler angle and the crucial angle of Gissane in paediatric population were measured using lateral foot radiographs of 429 patients, from 0 to 16 years of age. The control group was composed of 70 adult patients. The sample had a mean Bohler angle of 35.4° ± 5.9° and a mean crucial angle of Gissane of 110.5° ± 7.4°. The greater mean difference was identified for Bohler angle (8°) in the age group of 5 to 8 years (39.6° ± 5.7°) and for the crucial angle of Gissane (5°-6°) in the age group of 0 to 4 years (115.8° ± 7.3) (P < .05). The influence of the ossification centres on the geometry of the calcaneus across age groups makes Bohler angle and the crucial angle of Gissane higher in young children. The increase in Bohler angle points out the relative development of the posterior facet in young children and the importance of the reconstruction of the posterior facet height in the intra-articular calcaneus fractures.
Click to expand...

NewsBot · Jun 26, 2019

The physiological range of the Böhler's angle in the adult Croatian population.
Šimunović M et al
Foot Ankle Surg. 2019 Apr;25(2):174-179

BACKGROUND:
To examine the relationship of the Böhler's angle with age, sex, and laterality, and to analyze the interrater agreement.

METHODS:
After 248 digital lateral radiographs of the foot were submitted to exclusion criteria, three raters independently measured the Böhler's angle on the remaining 130 X-rays in PACS. The variables were analyzed with correlation coefficients, and one-way ANOVA. The repeated measures of ANOVA were computed across age groups (30-39, 40-49, 50-59, and 60-69 years). The interrater agreement was calculated using intraclass correlation coefficient (ICC).

RESULTS:
The mean value of the Böhler's angle was 34±5° (21-46°). It was not related to age (in general [p=0.057], and across groups [p from 0.107 to 0.122]), sex (p=0.344; p=0.342), and laterality (p=0.618; p=0.617). The interrater reliability was almost perfect (ICC=0.94).

CONCLUSIONS:
The Böhler's angle was not related to age, sex, and laterality, whereas the interrater agreement was almost perfect.
Click to expand...

NewsBot · Aug 2, 2019

Böhler's Angle-Comparison Between the pre- and Postoperative in Displaced Intra-Articular Calcaneal Fractures.
Labronici PJ et al
Rev Bras Ortop (Sao Paulo). 2019 Apr;54(2):156-164

Objective To compare pre- and postoperative variation of radiographic measurements of the Böhler angle (BA) in fractures with two types of deviations: severe and moderate. Methods Pre- and postoperative BAs in 31 calcaneal fracture radiographs were retrospectively analyzed. A total of 4 patients were female (6.5%) and 26 were male (83.9%), with age ranging from 23 to 72 years old, and a mean age of 44.5 years old. Results The results show that the postoperative BA was significantly larger than the preoperative BA ( p = 0.000). At the intraevaluator and overall assessments, the postoperative BA was, on average, 10.6° higher than the preoperative measure. The postoperative angle was, on average, 108% higher than the preoperative angle. In the global assessment, the agreement between evaluators was excellent, both regarding the estimated point value (0.98) and the intraclass correlation (ICC) confidence interval (CI). Conclusion In the global analysis, the postoperative BAs were, on average, significantly higher than the preoperative measurements. The farther from the normal range (20° to 40°) the preoperative angle is, the greater the difference after the surgery. When the preoperative angle was normal, the postoperative angle was, on average, 1.28 times the preoperative measurement. If the preoperative BA was abnormal, the postoperative angle was, on average, 17.3 times the preoperative measurement. It was demonstrated that more severe fractures present better anatomic results when compared with moderate fractures. The present study also confirms a good interobserver correlation for the BA.
Click to expand...

NewsBot · Jan 1, 2020

The Influence of Radiograph Obliquity on Böhler's and Gissane's Angles in Calcanei.
De Boer AS et al
J Foot AnkleSurg. 2020 Jan - Feb;59(1):44-47

In calcaneal fractures, Böhler's and Gissane's angles are considered important parameters to guide treatment strategy and provide prognostic information during follow-up visits. Therefore, lateral radiographs have to be accurate. The aim of this study was to evaluate the effect of craniocaudal and posteroanterior angular variations (i.e., simulate lower leg malposition) from the true lateral radiograph on Böhler's and Gissane's angles. In this radioanatomical study, 15 embalmed, skeletally mature, human anatomic lower limb specimens were used. Using predefined criteria, a true lateral radiograph (i.e., 0° angular variation) was obtained. Angular variations from this true lateral radiograph were made from -30° to +30° deviation in the craniocaudal and posteroanterior direction at 5° intervals. Böhler's and Gissane angles were independently assessed by 2 experienced trauma surgeons. Böhler's angle decreased with increasing caudal angular variations (maximum -4.3° deviation at -30°). With increasing of the posterior angular variations, Böhler's angle increased (maximum 5.0° deviation at +30°) from the true lateral radiograph, but all deviations were within the measurement error. The deviation of the angle of Gissane was most pronounced in the cranial direction, with the mean angle decreasing by -8.8° at +30° angular variation. Varying angular obliquity in the caudal and posteroanterior direction hardly affected Gissane's angle. Foot malpositioning during the making of a lateral radiograph has little influence on Böhler's and Gissane's angles. If used for clinical decision-making in initial treatment and during follow-up of calcaneal fractures, these parameters can reliably be obtained from any lateral radiograph.
Click to expand...

NewsBot · Jul 23, 2020

The Influence of Radiograph Obliquity on Böhler's and Gissane's Angles in Calcanei
A Siebe De Boer et al
J Foot Ankle Surg. Jan-Feb 2020;59(1):44-47

In calcaneal fractures, Böhler's and Gissane's angles are considered important parameters to guide treatment strategy and provide prognostic information during follow-up visits. Therefore, lateral radiographs have to be accurate. The aim of this study was to evaluate the effect of craniocaudal and posteroanterior angular variations (i.e., simulate lower leg malposition) from the true lateral radiograph on Böhler's and Gissane's angles. In this radioanatomical study, 15 embalmed, skeletally mature, human anatomic lower limb specimens were used. Using predefined criteria, a true lateral radiograph (i.e., 0° angular variation) was obtained. Angular variations from this true lateral radiograph were made from -30° to +30° deviation in the craniocaudal and posteroanterior direction at 5° intervals. Böhler's and Gissane angles were independently assessed by 2 experienced trauma surgeons. Böhler's angle decreased with increasing caudal angular variations (maximum -4.3° deviation at -30°). With increasing of the posterior angular variations, Böhler's angle increased (maximum 5.0° deviation at +30°) from the true lateral radiograph, but all deviations were within the measurement error. The deviation of the angle of Gissane was most pronounced in the cranial direction, with the mean angle decreasing by -8.8° at +30° angular variation. Varying angular obliquity in the caudal and posteroanterior direction hardly affected Gissane's angle. Foot malpositioning during the making of a lateral radiograph has little influence on Böhler's and Gissane's angles. If used for clinical decision-making in initial treatment and during follow-up of calcaneal fractures, these parameters can reliably be obtained from any lateral radiograph.
Click to expand...

NewsBot · Aug 18, 2020

Morphological analysis of Gissane's angle utilising a statistical shape model of the calcaneus
Beat Schmutz et al
Arch Orthop Trauma Surg. 2020 Aug 12

Introduction: Gissane's crucial angle (GA) facilitates to diagnose calcaneal fractures, and serves as an indicator of the quality of anatomical reduction after fixation. The study aimed to utilise statistical shape models (SSM) for analysing the complex 3D surface anatomy of the calcaneus represented by the simplified GA measurement on lateral radiographs.

Materials and methods: SSMs were generated from CT scans of paired adult calcanei from 10 Japanese and 31 Thai specimens. GA measurements in 3D and 2D were obtained for the lateral, central and medial anatomy of the posterior facet and sinus tarsi. The correlation between calcaneal length and GA was analysed. Regression and principal component (PC) analyses were conducted for analysing morphological variability in calcaneal shape relating to GA. The bilateral symmetry of the obtained measurements was analysed.

Results: The mean GA (lateral) for the Japanese specimens was 105.1° ± 7.5 and 105.4° ± 8.5 for the Thai. The projected 2D angles of the central and medial measurements were larger (P < 0.00) than the 3D values. The medial projected 2D angles were larger (P ≤ 0.02) compared to the lateral. Despite the bilateral symmetry of GA and calcaneal length, their correlation displayed clear signs of asymmetry, which was confirmed by regression and PC analyses.

Conclusions: Japanese and Thai specimens revealed lower GAs (both range and mean) compared to reported reference values of other ethnicities. As a reduced GA is generally indicative of a calcaneal fracture, our results are important to surgeons for their diagnostic assessment of Japanese and Thai patients. The results indicate that the GA measurement on a plain radiograph is a simplified representation of the lateral-to-central 3D calcaneal anatomy but significantly underestimates the angle measurement on the medial aspects of the respective surface areas.
Click to expand...

NewsBot The Admin that posts the news.

Attached Files:

bohlers.JPG

Admin2 Administrator Staff Member

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

The signed helical angle: A technique for characterizing midfoot motion during gait

MPJ and IPJ angle measurements

Changing foot progression angle rearfoot eversion during running

Kanglexin for diabetic foot ulcers

Number of fiber bundles of the anterior talofibular ligament and differences in the angle of the cal

Quadriceps angle and plantar pressure distribution

Relationship of tibial torsion and knee angles to hallux valgus

Share This Page