Calcaneal Morphometry in Children and Adults: Normative Values of the Bohler and Gissane Angles in a Turkish Population

Abstract

Objective: The Bohler angle (BA) and Gissane angle (GA) are key radiological parameters used in the assessment of calcaneal fractures, but population-specific normative data, particularly for pediatric individuals, remain limited. This retrospective, cross-sectional study aimed to establish normative values for BA and GA in pediatric (10–17 years) and adult (≥18 years) Turkish individuals, and to evaluate their variation by age, sex, and laterality.

Methodology: A total of 360 lateral foot/ankle radiographs (180 pediatric, 180 adult; sex-balanced) were measured using a standardized digital protocol, with reliability assessed via the intraclass correlation coefficient (ICC). Mean BA was significantly higher in the pediatric group (36.4 ± 6.8°) than in adults (32.4 ± 7.0°) (p < 0.001; Cohen's d = 0.578) and correlated negatively with age (r = −0.324; p < 0.001), with a quadratic model fitting better than a linear one.

Results: These findings indicate that adult BA reference values cannot be directly applied to pediatric patients, and provide clinicians with age-specific reference ranges for assessing calcaneal fractures.

Conclusion: These findings indicate that adult BA reference values cannot be directly applied to pediatric patients, and provide clinicians with age-specific reference ranges for assessing calcaneal fractures.