Böhler angle (Boehler angle, Bohler angle, tuber-joint angle, calcaneal angle)
The angle between line from highest point of anterior process to highest point of posterior facet plus line tangential to superior edge of tuberosity; measured on lateral foot x-ray. Normally 20-40°. If < 20° represents a calcaneal fracture (or more specifically a collapse of the posterior facet)
Normally there exists, between the upper contour of the tuberosity of the os calcis and the line uniting the highest point of the anterior process with the highest point of the posterior articular surface, an angle of thirty to thirty-five degrees. This angle I have named face is driven downward; the the “tuber-joint angle“. In fractures of the os calcis this angle becomes smaller, straight, or even reversedBöhler 1931
- Fig 5. Normal tuber-joint angle of 40 degrees in a normal os calcis. The longitudinal axis of the astragalus (talus) is inclined.
- Fig 6. Tuber-joint angle of 20 degrees in a mild fracture of the os calcis. The longitudinal axis of the astragalus (talus) approaches the horizontal
According to Buckley et al, patients with Bohler’s angle <10 degrees, comminuted fracture patterns, large initial joint step-off, women, non-workman’s compensation cases, and younger patients (age <29) have improved outcomes with surgery.
- Boehler’s angle, Bohler’s angle
- Tuber-joint angle, tuber angle
- Calcaneal angle
- Did they first describe or popularise or plagiarise?
- Böhler 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 Feb;20(2):122-4. [PMID 1996790]
- Sanders R. Intra-articular fractures of the calcaneus: present state of the art. J Orthop Trauma. 1992;6(2):252-265.
- Buckley R, Tough S, McCormack R, et al. Operative compared with nonoperative treatment of displaced intra-articular calcaneal fractures: a prospective, randomized controlled multicenter trial. J Bone Joint Surg Am. 2002;84:1733-1744.
- 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. The American Journal of Emergency Medicine, 2006; 24(4): 423–427 [PMID 16787799]
- Boyle MJ et al. The paediatric Bohler’s angle and crucial angle of Gissane: a case series. Journal of Orthopaedic Surgery and Research 2011, 6:2
- Arslan G, Yirgin IK, Tasguzen A. A measuremental approach to calcaneal fractures. Eur J Trauma Emerg Surg. 2014 Oct;40(5):593-9 [PMID 26814517]
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