C. Loucks et R. Buckley, Bohler's angle: Correlation with outcome in displaced intra-articular calcaneal fractures, J ORTHOP TR, 13(8), 1999, pp. 554-558
Objectives: Bohler's tuber joint angle is commonly assessed when evaluating
calcaneal fractures. A severe heel fracture will result in a significant d
ecrease or loss of this angle. The purpose of this study was to evaluate th
e correlation between Bohler's angle and functional outcome in displaced in
tra-articular calcaneal fractures.
Design: Prospective cohort study.
Setting: Level I trauma center.
Methods: Ninety-five fractures in eighty-eight patients were analyzed for c
linical outcome as measured by previously validated visual analogue scale (
VAS) and SF-36 Health Survey scores. Radiographic results were measurements
of Bohler's angle on plain x-rays. Angles were measured twice by two obser
vers working independently.
Results: This prospective randomized cohort study indicates that patients i
nitially presenting with a severely depressed Bohler's angle have a poor tw
o-year outcome regardless of treatment. As well, fractures of lesser initia
l displacement, as measured by Bohler's angle, had higher functional scores
on both VAS and SF-36 scoring scales.
Conclusion: In this study, Bohler's angle had significant prognostic value
in terms of predicting morbidity. Fractures with a markedly diminished Bohl
er's angle demonstrated a much poorer two-year outcome regardless of treatm
ent. It would seem that the initial Bohler's angle was highly prognostic, r
egardless of treatment modality.