Labronici Pedro José, Faria Guilherme Guerra Pinheiro de, Pedro Bruno Miranda, Serra Marcos Donato Franco de Araújo, Pires Robinson Esteves Santos, Tamontini Jorge Luiz
Serviço de Ortopedia e Traumatologia, Hospital Santa Teresa, Petrópolis, RJ, Brasil.
Universidade Federal Fluminense, Niterói, RJ, Brasil.
Rev Bras Ortop (Sao Paulo). 2019 Apr;54(2):156-164. doi: 10.1016/j.rbo.2017.12.005. Epub 2019 Apr 22.
To compare pre- and postoperative variation of radiographic measurements of the Böhler angle (BA) in fractures with two types of deviations: severe and moderate. Pre- and postoperative BAs in 31 calcaneal fracture radiographs were retrospectively analyzed. A total of 4 patients were female (6.5%) and 26 were male (83.9%), with age ranging from 23 to 72 years old, and a mean age of 44.5 years old. The results show that the postoperative BA was significantly larger than the preoperative BA ( = 0.000). At the intraevaluator and overall assessments, the postoperative BA was, on average, 10.6° higher than the preoperative measure. The postoperative angle was, on average, 108% higher than the preoperative angle. In the global assessment, the agreement between evaluators was excellent, both regarding the estimated point value (0.98) and the intraclass correlation (ICC) confidence interval (CI). In the global analysis, the postoperative BAs were, on average, significantly higher than the preoperative measurements. The farther from the normal range (20° to 40°) the preoperative angle is, the greater the difference after the surgery. When the preoperative angle was normal, the postoperative angle was, on average, 1.28 times the preoperative measurement. If the preoperative BA was abnormal, the postoperative angle was, on average, 17.3 times the preoperative measurement. It was demonstrated that more severe fractures present better anatomic results when compared with moderate fractures. The present study also confirms a good interobserver correlation for the BA.
比较两种类型偏差（严重和中度）骨折中跟骨角（BA）的影像学测量术前和术后的变化。对31例跟骨骨折X线片的术前和术后BA进行回顾性分析。共有4例女性（6.5%）和26例男性（83.9%），年龄范围为23至72岁，平均年龄44.5岁。结果显示，术后BA显著大于术前BA（P = 0.000）。在评估者内部和总体评估中，术后BA平均比术前测量值高10.6°。术后角度平均比术前角度高108%。在总体评估中，评估者之间在估计点值（0.98）和组内相关系数（ICC）置信区间（CI）方面的一致性都非常好。在总体分析中，术后BA平均显著高于术前测量值。术前角度离正常范围（20°至40°）越远，术后差异越大。当术前角度正常时，术后角度平均是术前测量值的1.28倍。如果术前BA异常，术后角度平均是术前测量值的17.3倍。结果表明，与中度骨折相比，更严重的骨折呈现出更好的解剖学结果。本研究还证实了BA在观察者之间具有良好的相关性。
