Can Bohler’s 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, Bohlerâ€™s angle can be used as a tool to achieve articular congruity intraoperatively. But a debate exists whether surgical restoration of Bohlerâ€™s angle to normal range in calcaneal fractures can ensure good functional outcome. Many studies have found no correlation between Bohlerâ€™s angle and the ultimate functional outcome.
Aim: To investigate whether correlation exists between the operative restoration of Bohlerâ€™s 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 Bohlerâ€™s 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 Bohlerâ€™s angle preoperatively did not correlate with functional outcome. Postoperative Bohlerâ€™s angle correlated significantly with AOFAS hind foot score and Visual analogue scale.
Conclusion: Intraoperative restoration of Bohlerâ€™s angle to >18 degrees correlated strongly with the ultimate functional outcome. Therefore, aim of treatment in calcaneal fractures should be restoration of Bohlerâ€™s angle to near normal value.