Can Bohlerís Angle Predict the Functional Results of Intra-Articular Displaced Calcaneal Fractures? RC05-RC07
Dr. Atmananda Hegde,
Department of Orthopaedics, KMC, MAHE, Attavara, Mangalore-575001, Karnataka, India.
Introduction: Intra-articular fractures need to be anatomically reduced. In intra-articular calcaneal fractures, Bohlerís angle can be used as a tool to achieve articular congruity intraoperatively. But a debate exists whether surgical restoration of Bohlerís angle to normal range in calcaneal fractures can ensure good functional outcome. Many studies have found no correlation between Bohlerís angle and the ultimate functional outcome.
Aim: To investigate whether correlation exists between the operative restoration of Bohlerís angle and the functional outcome.
Materials and Methods: Forty patients with closed intra-articular displaced calcaneal fracture were studied. The injury was classified according to Sanders classification. Preoperative and postoperative Bohlerís angle was determined from radiographs. The functional outcome was assessed using American Orthopaedic Foot & Ankle Society hind foot score (AOFAS) and Visual Analogue Scale (VAS).
Results: Forty patients were enrolled in the study with a follow up period of 12 months. As per Sanders classification, there were 14 Type II, 14 Type III and 12 Type IV fractures. The Bohlerís angle preoperatively did not correlate with functional outcome. Postoperative Bohlerís angle correlated significantly with AOFAS hind foot score and Visual analogue scale.
Conclusion: Intraoperative restoration of Bohlerís angle to >18 degrees correlated strongly with the ultimate functional outcome. Therefore, aim of treatment in calcaneal fractures should be restoration of Bohlerís angle to near normal value.