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Os calcaneus angles in dry bones of Turkish population

Year 2020, Volume: 45 Issue: 4, 1707 - 1712, 27.12.2020
https://doi.org/10.17826/cumj.781515

Abstract

Purpose: The aim of this study was to evaluate calcaneus angles in dry bones belonging to Turkish population.
Materials and Methods: Dry calcaneal bones which age and sex were unknown belonging to Cukurova University Faculty of Medicine were used in this study. The photographs of the bones were taken under fixed light and distance, positioned like lateral direct graph, the Böhler (BA) and Gissane (GA) angles were measured according to the reference points using the digital design program (SketchUp 2016). Calculation sensitivity was 1/10°. Angle value distrubitons and left right relations were examined. After the measurements minimum-maximum, median and standart deviation values were obtained.
Results: Total of 67 dry bones were clasified as left and right. The average BA was measured as (minimum-maximum); 29.68°±4.71° (20.00°-39.80°) on the right side and 31.54°±4.88° (20.20°-41.20°) on the left side. GA average was measured as (minimum-maximum); 102.96°±5.25° (93.70°-114.5°) on the right side, 103.89°±7.14° (93.10°-120.4°) on the left side. For both angles no significant difference was found between left and right calcaneus.
Conclusions: Calcaneus angles may differ between races and populations. These angular values are important in determining calcaneus fractures. Base values of these angles are especially important in determining the baseline values which will be useful in practice. In literature the risk of fractures (especially displaced fractures) increases as the Böhler Angle and Gissane Angle approach the lower limits. Therefore, values obtained in this study will contribute establishing reference values in Turkish population.

Thanks

We would like to thank Prof. Dr. Ahmet Hilmi Yücel for his contributions to this study.

References

  • Yücel AH (editor). Dere Anatomi Atlası ve Ders Kitabı. 7. Baskı. Akademisyen Kitabevi. Adana. 2018.
  • Giachino AA, Uhthoff HK. Intra-articular fractures of the calcaneus. J Bone Joint Surg Am. 1989;71(5):784-7.
  • Pozo JL, Kirwan EO, Jackson AM. The long-term results of conservative management of severely displaced fractures of the calcaneus. J Bone Joint Surg Br. 1984;66(3):386-90.
  • Jarvholm U, Korner L, Thoren O. Wiklund LM. Fractures of the calcaneus. A comparison of open and closed treatment. Acta Orthop Scand. 1984;55(6):652-6.
  • Sanders R. Intra-articular fractures of the calcaneus: present state of the art. J Orthop Trauma. 1992;6(2):252-65.
  • Leung KS, Yuen KM, Chan WS. Operative treatment of displaced intra-articular fractures of the calcaneum Mediumterm results. J Bone Joint Surg Br. 1993;75(2):196-201.
  • Işıklar ZU, Bilen FE. Kalkaneus kırıkları. TOTBİD. 2006;5(1-2): 44-52.
  • Shuler FD, Conti SF, Gruen GS, Abidi NA. Wound-healing risk factors after open reduction and internal fixation of calcaneal fractures: does correction of Bohler’s angle alter outcomes? Orthop Clin North Am. 2001;32:187-92.
  • Silhanek AD, Ramdass R, Lombardi CM. The effect of primary fracture line location on the pattern and severity of intraarticular calcaneal fractures: a retrospective radiographic study. J Foot Ankle Surg. 2006;45:211-9.
  • Bohler L. Diagnosis pathology and treatment of fractures of the os calcis. J Bone Joint Surg. 1931;13:75-89.
  • Chen MY, Bohrer SP, Kelley TF. Boehler’s angle: a reappraisal. Ann Emerg Med. 1991;20:122-4.
  • Didia BC, Dimkpa JN. The calcaneal angle in Nigerians. Relationship to sex. age. and side of the body. J Am Podiatr Med Assoc. 1999;89:472-4.
  • Igbigbi PS. Mutesasira AN. Calcaneal angle in Ugandans. Clin Anat. 2003;16:328-30.
  • Khoshhal KI, Ibrahim AF, Al-Nakshabandi NA, Zamzam MM, Al-Boukai AA, Zamzami MM. Bohler’s and Gissane’s angles of the calcaneus in the Saudi population. Saudi Med J. 2004;25:1967-70.
  • Hauser ML, Kroeker RO. Boehler’s angle: a review and study. J Am Podiatry Assoc. 1975;65:517-21.
  • Knight JR, Gross EA, Bradley GH, Bay C, LoVecchio F. Boehler’s angle and the critical angle of Gissane are of limited use in diagnosing calcaneus fractures in the ED. Am J Emerg Med. 2006;24:423-7.
  • Loucks C, Buckley R. Bohler’s angle: correlation with outcome in displaced intra-articular calcaneal fractures. J Orthop Trauma. 1999;13:554-8.
  • Seyahi A, Uludağ S, Koyuncu LÖ, Atalar AC, Demirhan M. Türk toplumunda kalkaneus açıları. Acta Orthop Traumatol Turc. 2009; 43(5): 406-11.
  • Boyle MJ, Walker CG, Crawford HA. The paediatric Bohler’s angle and crucial angle of Gissane: a case series. J Orthop Surg Res. 2011;6:2-5.
  • Shoukry FA, Aref YK, Sabry AE. Evaluation of the normal calcaneal angles in Egyptian population. AJM. 2012;48. 91–7.
  • Ramachandran R, Shetty S. Assessment of Bohler’s and Gıssane’s angles of the calcaneum in a group of South Indian population a radiological study. Int J Cur Res Rev. 2015; 7(15): 17-20.
  • Živanović-Mačužić I, Vulović M. Vojinović R, Jovanović M, Radunović A, Milev B, Cvetković A, Stojiljković M, Milošević B, Ivošević A, Aksić M, Simović M, Jeremić D. The Böhler’s angle in population of central Serbia a radiological study. Vojnosanit Pregl. 2018; 75(3): 241-5.
  • Schepers T, Ginai AZ, Mulder PGH, Patka P. Radiographic evaluation of calcaneal fractures: to measure or not to measure. Skeletal Radiol. 2007;36:847–52.
  • Sengodan VC, Amruth KH, Karthikeyan K. Bohler’s and Gissane angles in the Indian population. JCIS. 2012;2(77):1-8.
  • Isaacs JD, Baba M, Huang P, Symes M, Guzman M, Nandapalan H, Moopanar T, Marchalleck S, Szomor Z. The diagnostic accuracy of Bohler’s angle in fractures of the calcaneus. JEM. 2013;45(6):879–84.
  • Polat A, Demirtaş A, Azboy İ, Uçar BY, Coşar Y, Gümüşsuyu G et al. The effect of fracture type and angular deterioration on the functional outcome of calcaneal fractures. Dicle Med J. 2011;38(1):35-9.
  • Redfern DJ, Oliveira ML, Campbell JT, Belkoff SM. A biomechanical comparison of locking and nonjocking plates for the fixation of calcaneal fractures. Foot Ankle Int. 2006;27(3):196-201.
  • Stoffel K, Booth G, Rohrl SM, Kuster M. A comparison of conventional versus locking plates in intraarticular calcaneus fractures: a biomechanical study in human cadavers. Clin Biomech. 2007;22(1):100-5.
  • Richter M, Droste P, Goesling T, Zech S, Krettek C. Polyaxially-locked plate screws increase stability of fracture fıxation in an experimental model of calcaneal fracture. J Bone Joint Surg. 2006;9:257-63.
  • Kumar V, Hameed A, Bhattacharya R, McMurtry I. Role of computerised tomography in management of intra-articular fractures of the os calcis. Int Orthop. 2006;30(2):10-2.
  • Özkaya U, Kabukçuoğlu Y, Parmaksızoğlu AS, Kılıç A, Sökücü S, Basılgan S. Eklem içi kalkaneus kırıklarının açık redüksiyon ve internal fiksasyon ile tedavi sonuçları. Kartal Eğit Araşt Hastane Tıp Derg. 2007;18(2):57-64.
  • Willmott H, Stanton J, Southgate C. Bohler’s angle – What is normal in the uninjured British population? Foot and Ankle Surgery. 2012;18:187-89.

Türk toplumuna ait kuru kemiklerde Os calcaneus açıları

Year 2020, Volume: 45 Issue: 4, 1707 - 1712, 27.12.2020
https://doi.org/10.17826/cumj.781515

Abstract

Amaç: Türk toplumuna ait kuru kemiklerden os calcaneus açılarının değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Çukurova Üniversitesi Tıp Fakültesi Anatomi Anabilim Dalı'na ait yaşı ve cinsiyeti belli olmayan 67 adet os calcaneus kullanıldı. Sabit ışık altında ve sabit mesafeden lateral direkt grafideki pozisyonuna uygun şekilde konumlandırılan kemiklerin fotoğrafları çekildi, referans noktaları deforme olan kemikler ölçümden çıkartıldı, referans çizgiler aracılığı ile Böhler (BA) ve Gissane (GA) açıları dijital tasarım programı (SketchUp 2016) kullanılarak ölçüldü. Ölçümler 1/100 mm duyarlıkta yapıldı. Açıların dağılım özellikleri ve sağ-sol taraf ilişkisi incelendi. Bu ölçümlerden sonra minimum-maksimum, ortalama ve standart sapma değerleri elde edildi.
Bulgular: Toplam 67 kuru kemikten sağ ve sol olmak üzere iki grup oluşturuldu. Böhler açısı ortalama (minimum-maksimum) değeri sağ tarafta; 29,68°±4,71° (20,00°-39,80°), sol tarafta; 31,54°±4,88° (20,20°-41,20°), Gissane açısının ortalama (minimum-maksimum) değeri sağ tarafta; 102,96°±5,25° (93,70°-114,5°), sol tarafta; 103,89°±7,14° (93,10°-120,40°) olarak bulundu. Her iki açı için sağ ve sol taraf arasında anlamlı fark bulunmadı.
Sonuç: Os calcaneus açıları farklı ırk ve toplumlarda farklı dağılım gösterebilir. Bu açıların değerleri os calcaneus kırıklarının belirlenmesinde önem arz etmaktedir. Özellikle taban değerlerinin belirlenmesi uygulamalarda yarar sağlayacaktır. Literatüre bakıldığında, Böhler ve Gissane açı değerleri alt sınırlara yaklaştıkça kırık (özellikle deplase kırıklar) riskinin arttığı görülmektedir. Çalışmamızda saptadığımız değerler Türk toplumuna ait referans değerlerin belirlenmesine katkı sağlayacaktır.

References

  • Yücel AH (editor). Dere Anatomi Atlası ve Ders Kitabı. 7. Baskı. Akademisyen Kitabevi. Adana. 2018.
  • Giachino AA, Uhthoff HK. Intra-articular fractures of the calcaneus. J Bone Joint Surg Am. 1989;71(5):784-7.
  • Pozo JL, Kirwan EO, Jackson AM. The long-term results of conservative management of severely displaced fractures of the calcaneus. J Bone Joint Surg Br. 1984;66(3):386-90.
  • Jarvholm U, Korner L, Thoren O. Wiklund LM. Fractures of the calcaneus. A comparison of open and closed treatment. Acta Orthop Scand. 1984;55(6):652-6.
  • Sanders R. Intra-articular fractures of the calcaneus: present state of the art. J Orthop Trauma. 1992;6(2):252-65.
  • Leung KS, Yuen KM, Chan WS. Operative treatment of displaced intra-articular fractures of the calcaneum Mediumterm results. J Bone Joint Surg Br. 1993;75(2):196-201.
  • Işıklar ZU, Bilen FE. Kalkaneus kırıkları. TOTBİD. 2006;5(1-2): 44-52.
  • Shuler FD, Conti SF, Gruen GS, Abidi NA. Wound-healing risk factors after open reduction and internal fixation of calcaneal fractures: does correction of Bohler’s angle alter outcomes? Orthop Clin North Am. 2001;32:187-92.
  • Silhanek AD, Ramdass R, Lombardi CM. The effect of primary fracture line location on the pattern and severity of intraarticular calcaneal fractures: a retrospective radiographic study. J Foot Ankle Surg. 2006;45:211-9.
  • Bohler L. Diagnosis pathology and treatment of fractures of the os calcis. J Bone Joint Surg. 1931;13:75-89.
  • Chen MY, Bohrer SP, Kelley TF. Boehler’s angle: a reappraisal. Ann Emerg Med. 1991;20:122-4.
  • Didia BC, Dimkpa JN. The calcaneal angle in Nigerians. Relationship to sex. age. and side of the body. J Am Podiatr Med Assoc. 1999;89:472-4.
  • Igbigbi PS. Mutesasira AN. Calcaneal angle in Ugandans. Clin Anat. 2003;16:328-30.
  • Khoshhal KI, Ibrahim AF, Al-Nakshabandi NA, Zamzam MM, Al-Boukai AA, Zamzami MM. Bohler’s and Gissane’s angles of the calcaneus in the Saudi population. Saudi Med J. 2004;25:1967-70.
  • Hauser ML, Kroeker RO. Boehler’s angle: a review and study. J Am Podiatry Assoc. 1975;65:517-21.
  • Knight JR, Gross EA, Bradley GH, Bay C, LoVecchio F. Boehler’s angle and the critical angle of Gissane are of limited use in diagnosing calcaneus fractures in the ED. Am J Emerg Med. 2006;24:423-7.
  • Loucks C, Buckley R. Bohler’s angle: correlation with outcome in displaced intra-articular calcaneal fractures. J Orthop Trauma. 1999;13:554-8.
  • Seyahi A, Uludağ S, Koyuncu LÖ, Atalar AC, Demirhan M. Türk toplumunda kalkaneus açıları. Acta Orthop Traumatol Turc. 2009; 43(5): 406-11.
  • Boyle MJ, Walker CG, Crawford HA. The paediatric Bohler’s angle and crucial angle of Gissane: a case series. J Orthop Surg Res. 2011;6:2-5.
  • Shoukry FA, Aref YK, Sabry AE. Evaluation of the normal calcaneal angles in Egyptian population. AJM. 2012;48. 91–7.
  • Ramachandran R, Shetty S. Assessment of Bohler’s and Gıssane’s angles of the calcaneum in a group of South Indian population a radiological study. Int J Cur Res Rev. 2015; 7(15): 17-20.
  • Živanović-Mačužić I, Vulović M. Vojinović R, Jovanović M, Radunović A, Milev B, Cvetković A, Stojiljković M, Milošević B, Ivošević A, Aksić M, Simović M, Jeremić D. The Böhler’s angle in population of central Serbia a radiological study. Vojnosanit Pregl. 2018; 75(3): 241-5.
  • Schepers T, Ginai AZ, Mulder PGH, Patka P. Radiographic evaluation of calcaneal fractures: to measure or not to measure. Skeletal Radiol. 2007;36:847–52.
  • Sengodan VC, Amruth KH, Karthikeyan K. Bohler’s and Gissane angles in the Indian population. JCIS. 2012;2(77):1-8.
  • Isaacs JD, Baba M, Huang P, Symes M, Guzman M, Nandapalan H, Moopanar T, Marchalleck S, Szomor Z. The diagnostic accuracy of Bohler’s angle in fractures of the calcaneus. JEM. 2013;45(6):879–84.
  • Polat A, Demirtaş A, Azboy İ, Uçar BY, Coşar Y, Gümüşsuyu G et al. The effect of fracture type and angular deterioration on the functional outcome of calcaneal fractures. Dicle Med J. 2011;38(1):35-9.
  • Redfern DJ, Oliveira ML, Campbell JT, Belkoff SM. A biomechanical comparison of locking and nonjocking plates for the fixation of calcaneal fractures. Foot Ankle Int. 2006;27(3):196-201.
  • Stoffel K, Booth G, Rohrl SM, Kuster M. A comparison of conventional versus locking plates in intraarticular calcaneus fractures: a biomechanical study in human cadavers. Clin Biomech. 2007;22(1):100-5.
  • Richter M, Droste P, Goesling T, Zech S, Krettek C. Polyaxially-locked plate screws increase stability of fracture fıxation in an experimental model of calcaneal fracture. J Bone Joint Surg. 2006;9:257-63.
  • Kumar V, Hameed A, Bhattacharya R, McMurtry I. Role of computerised tomography in management of intra-articular fractures of the os calcis. Int Orthop. 2006;30(2):10-2.
  • Özkaya U, Kabukçuoğlu Y, Parmaksızoğlu AS, Kılıç A, Sökücü S, Basılgan S. Eklem içi kalkaneus kırıklarının açık redüksiyon ve internal fiksasyon ile tedavi sonuçları. Kartal Eğit Araşt Hastane Tıp Derg. 2007;18(2):57-64.
  • Willmott H, Stanton J, Southgate C. Bohler’s angle – What is normal in the uninjured British population? Foot and Ankle Surgery. 2012;18:187-89.
There are 32 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research
Authors

Ayşe Gül Kabakcı 0000-0001-7144-8759

Rümeysa Gamze Taşkın 0000-0001-5587-1055

Yiğit Çevik 0000-0002-2691-3284

Publication Date December 27, 2020
Acceptance Date September 30, 2020
Published in Issue Year 2020 Volume: 45 Issue: 4

Cite

MLA Kabakcı, Ayşe Gül et al. “Os Calcaneus Angles in Dry Bones of Turkish Population”. Cukurova Medical Journal, vol. 45, no. 4, 2020, pp. 1707-12, doi:10.17826/cumj.781515.