Journal article
There is poor reliability of Böhler's angle and the crucial angle of Gissane in assessing displaced intra-articular calcaneal fractures
Foot and ankle surgery, Vol.21(4), pp.277-281
12/2015
DOI: 10.1016/j.fas.2015.03.001
PMID: 26564731
Abstract
Two-dimensional measurements are used to describe displaced intra-articular calcaneal fractures (DIACF). Our study evaluates the performance of Böhler's angle (BA) and the crucial angle of Gissane (CAG) among orthopedic surgeons.
Thirty-four pre- and post-operative lateral foot radiographs from patients with DIACF were shown to four orthopedic surgeons who measured BA and the CAG. The intra- and inter-observer reliability were calculated using the intra-class correlation coefficient (ICC). Additionally, we calculated frequency of consensus given an allowed discrepancy. We then determined the tolerance limit for each measurement.
The ICC for inter-observer reliability of BA was 0.83 in the first session and 0.77 in the second. The ICC for intra-observer reliability ranged from 0.83 to 0.98. For the CAG, the inter-observer ICC was 0.28 and 0.1 in the two sessions. Intra-observer ICC ranged from 0.16 to 0.67. With an allowed discrepancy of 20°, there was lack of consensus for BA in 37.5% and for the CAG in 59% of measurements on average. The 95% confidence interval for 90% agreement in BA involved a range of 76°. For CAG, the 95% confidence interval of tolerance for 90% agreement was 56°.
For BA and CAG, there is frequent disagreement among experienced observers, even given a wide tolerance range. We recommend use of caution when applying BA as currently measured in making treatment decisions for DIACF.
Diagnostic, level III.
Details
- Title: Subtitle
- There is poor reliability of Böhler's angle and the crucial angle of Gissane in assessing displaced intra-articular calcaneal fractures
- Creators
- Jesse E Otero - University of Iowa Hospitals and Clinics Department of Orthopaedic Surgery and Rehabilitation, 200 Hawkins Drive, John Pappajohn Pavilion 01085 JPP, Iowa City, IA 52242 United States. Electronic address: jesse-otero@uiowa.eduBrian O Westerlind - University of Iowa Hospitals and Clinics Department of Orthopaedic Surgery and Rehabilitation, 200 Hawkins Drive, John Pappajohn Pavilion 01085 JPP, Iowa City, IA 52242 United StatesSaran Tantavisut - University of Iowa Hospitals and Clinics Department of Orthopaedic Surgery and Rehabilitation, 200 Hawkins Drive, John Pappajohn Pavilion 01085 JPP, Iowa City, IA 52242 United StatesMatthew D Karam - University of Iowa Hospitals and Clinics Department of Orthopaedic Surgery and Rehabilitation, 200 Hawkins Drive, John Pappajohn Pavilion 01085 JPP, Iowa City, IA 52242 United StatesPhinit Phisitkul - University of Iowa Hospitals and Clinics Department of Orthopaedic Surgery and Rehabilitation, 200 Hawkins Drive, John Pappajohn Pavilion 01085 JPP, Iowa City, IA 52242 United StatesCraig C Akoh - University of Iowa Hospitals and Clinics Department of Orthopaedic Surgery and Rehabilitation, 200 Hawkins Drive, John Pappajohn Pavilion 01085 JPP, Iowa City, IA 52242 United StatesYubo Gao - University of Iowa Hospitals and Clinics Department of Orthopaedic Surgery and Rehabilitation, 200 Hawkins Drive, John Pappajohn Pavilion 01085 JPP, Iowa City, IA 52242 United StatesJ Lawrence Marsh - University of Iowa Hospitals and Clinics Department of Orthopaedic Surgery and Rehabilitation, 200 Hawkins Drive, John Pappajohn Pavilion 01085 JPP, Iowa City, IA 52242 United States
- Resource Type
- Journal article
- Publication Details
- Foot and ankle surgery, Vol.21(4), pp.277-281
- Publisher
- France
- DOI
- 10.1016/j.fas.2015.03.001
- PMID
- 26564731
- ISSN
- 1268-7731
- eISSN
- 1460-9584
- Language
- English
- Date published
- 12/2015
- Academic Unit
- Orthopedics and Rehabilitation; Internal Medicine
- Record Identifier
- 9984040394502771
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