Anatomic and radiographic study of Egyptian calcaneal angles in comparison to other populations

ABSTRACT

This study was performed to determine the mean Egyptian calcaneal angles Bohler's angle [BA] and Gissane's angle [GA] in comparison to other populations. Lateral plain radiographs of 267 normal Egyptians' feet and ankles, of 184 females and 83 males, with an age range of 17-69 years, were studied retrospectively at Erfan hospital Jeddah KSA, between August 2005 to July 2006. Six reformatted CT scans and Eight MRI of the ankle were studied measuring the BA and GA to determine the fallacies in radiographic readings. In addition, 30 adult dry calcaneal bones [17 right and 13 left], 7 of which were of known sex [5 males and 2 females] were collected from the Anatomy Department, Faculty of Medicine, Ain Shams University. The values of BA and GA were estimated on the dry bones and their lateral plain radiographs. The range, mean and standard deviation of each angle were calculated. Using the student t-test and One-Way Analysis of Variance, the presence of statistical differences between age, gender and side of the body were determined for both angles. Moreover, the results of the present study were compared with those of other populations to determine any racial differences. The mean of BA in the Egyptian population was 31.5° with a range of 15-48° in males and 30.5° with a range of 19-42° in females. The mean of GA was 117° with a range of 100-134° in males and 125° with a range of 101-149° in females. Bohler's angle and GA were not significantly related to gender or side of the body. However, there were statistical significant differences between different age groups. Moreover, the range of both angles was greater than that reported in other population-samples. No significant different values were obtained between dry bones and those of plain radiographs. This study showed the statistical dissimilarity between the different populations as regards to BA and GA and reinforced the need to establish the normal ranges of BA and GA in a given population. These angles were shown to be an accepted method for quantifying fracture displacement and predicting the prognosis of calcaneal fractures. By using simple radiographic measurements, the data of the present study might lead to better diagnosis and treatment