The fate of Bohler's angle in conservatively-treated displaced intra-articular calcaneal fractures

Berdine Bakker, Jens Halm, Esther M.M. Van Lieshout, Tim Schepers

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Abstract

Purpose Although the predictive value of Bohler's angle on outcome remains subject of debate, the initial angle at the time of trauma still guides treatment. Changes in Bohler's angle during follow-up are frequently reported following surgical treatment of displaced intra-articular calcaneal fractures (DIACF). The aim of the present study was to determine the changes in Bohler's angle as a measure of secondary fracture displacement following conservative management of DIACF. Methods Thirty-eight patients with a total of 44 displaced intra-articular calcaneal fractures treated conservatively with a minimum of two lateral radiographs during follow-up were analysed. Bohler's angle at different follow-up times was measured by three observers. The change in angle was compared with the angle at trauma, and influence of trauma mechanism and common calcaneal fracture classifications were determined. Results The results showed a significant decline over time of the Bohler's angle in conservatively-treated patients of more than 11A degrees on average at a mean follow-up of 29.2 weeks. This decrease was not related to gender, the initial angle, or the Essex-Lopresti or Sanders classification. A statistically significantly higher decrease was detected in high energetic trauma compared with low energetic trauma. Conclusion The conservative treatment of displaced intra-articular calcaneal fractures is still a viable option, yet a significant secondary displacement in time should be taken into account, as reflected in a decrease of Bohler's angle of 11A degrees up to one year following trauma.
Original languageUndefined/Unknown
Pages (from-to)2495-2499
Number of pages5
JournalInternational Orthopaedics
Volume36
Issue number12
DOIs
Publication statusPublished - 2012

Research programs

  • EMC MUSC-01-47-01

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