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Boehler's angle: a reappraisal.
M Y Chen1, S P Bohrer, T F Kelley
1Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27103.
Annals of Emergency Medicine
|February 1, 1991
Summary
Boehler's angle, crucial for diagnosing calcaneal fractures, showed no significant variation based on sex or side of the body. Adjusting the lower limit of normal for Boehler's angle can reduce false positives in fracture diagnoses.
Area of Science:
- Radiology
- Orthopedic diagnostics
- Medical imaging analysis
Background:
- Boehler's angle is a radiographic measurement used in diagnosing calcaneal fractures.
- Previous studies have not definitively established factors influencing Boehler's angle measurements.
Purpose of the Study:
- To re-evaluate Boehler's angle.
- To assess the impact of central beam centering, patient sex, and body side on Boehler's angle measurements.
Main Methods:
- Retrospective clinical review of 120 patients with ankle injuries.
- Analysis of ankle and foot radiographs from a Level I trauma center.
Main Results:
- The mean Boehler's angle was 30° ± 6° (range 14°-50°).
- No statistically significant differences were found between sexes or sides of the body (P > .05).
- Minor variations in central beam positioning did not significantly affect the angle.
Conclusions:
- Using 28° as the lower limit of normal results in 31% false positives.
- A lower limit of 20° reduces false positives to 2.5%, and 18° (mean - 2 SD) reduces it to less than 1%.