Ângulo de böhler: comparação entre o pré e pós operatório nas fraturas intra articulares desviadas do calcanhar

Abstract

To compere the variation ofthe results in the radiographic measures ofthe Böhler’s angle, in the pre- and postoperative, in fractures with two types of deviations: severe and moderate. Methods: The Böhler’s angle of 31 radiographs were analyzed retrospectively, pre- and postoperative to the calcaneal fracture. Four patients were female (6.5%) and 26 male (83.9%),with age ranging from 23 to 72 years, mean of 44.5 years.Results: The pre- and postoperative measurements demonstrated that the postoperative Böhler’s angle is significantly larger than the preoperative Böhler’s angle preoperative (p-value = 0.000). For the intra-evaluator and overall assessments, the Böhler’s angle pos toperative was, on average, 10.6 degrees higher than in the preoperative period. The postoperative angle was, on average, 108% higher than the preoperative angle. In the global assessment, the agreement between the evaluators was excellent, both in relation to the estimated point value (0.98), and in relation to the ICC confidence interval.Conclusion: In the global analysis, it was verified that Böhler’s angle measurements in the postoperative were, on average, significantly higher than in the preoperative period. The further from the range of normality (20 to 40 degrees) the preoperative angle was, the more the difference in the angle after the surgery. When the preoperative angle was in the range of normality, the postoperative angle was, on average, 1.28 times the preoperative angle. If the preoperative Böhler’s angle was out of the range of normality, the postoperative angle was, on average, 17.3 times the preoperative angle. It was demonstrated that more severe fractures present better anatomic results when compared with moderate fractures. This study also confirms a good interobserver correlation for the Böhler’s angle.