Postnatal Growth of the Calcaneus Does not Simulate Growth of the Foot
ABSTRACT In the absence of age and sex-specific normative data for postnatal growth of the calcaneus, it has been hypothesized that the growth of the calcaneus would simulate growth of the foot.
A total of 860 normal lateral foot radiographs, 50 (25 female and 25 male) for each year of development from 1 to 18 years, and 10 radiographs from birth till 1 year, were measured for the length and height of the calcaneus, Bohler angle, the appearance, fusion and fragmentation of calcaneus apophysis, and the height and width of apophysis. Nonlinear curves were fit to a growth chart of the calcaneus, and the results were superimposed on the historical growth charts of the foot, stature, and long bones (femur, tibia). The ratio of calcaneus length to apophysis height was calculated.
Growth of the calcaneus does not simulate growth of the foot (which attains 50% of its mature dimension by the age of 1 y in girls and 1.5 y in boys), but simulates the growth of the long bones, which attain 50% of their mature length after the age of 3 years in girls and 4 years in boys. Bohler angle remains within normal limits across all ages. When the length of calcaneus is triple the height of its apophysis, 80% of calcaneus growth is complete.
We provide normative data for postnatal growth of the calcaneus. On the basis of these data, the assumption that growth disturbance in children affects the length of the calcaneus proportionately less than similar disturbances in the long bones, is false. Children <3 years have at least 50% of growth remaining. Bohler angle should be maintained at all ages.
This study of postnatal growth of the calcaneus provides age and sex-based normative data to predict growth pattern of calcaneus.
American Journal of Physical Anthropology 06/1956; 14(2):287 - 308. DOI:10.1002/ajpa.1330140221 · 2.51 Impact Factor
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ABSTRACT: Stature (height) is an important factor in establishing the identity of a person in the living as well as in the skeletonized state. When stature is estimated from the bones of the limbs, regression equations, which estimate the ratios of the lengths of bones to the height of the individual, are generated. The majority of bones that were used previously were the long bones. The calcaneus was used for estimating stature only in American whites and blacks (Holland  Am. J. Phys. Anthropol. 96:315-320). The regression equations that he generated were found to be useful for stature estimation in these population groups. Since the calcaneus has not been used for the same purpose in South Africa, the aim of this study was to derive regression equations that will allow this bone to be used for stature estimation in South African blacks. In total, 116 complete skeletons (60 males and 56 females) were selected from the Raymond A. Dart Collection of Human Skeletons, School of Anatomical Sciences, University of the Witwatersrand (Johannesburg, South Africa). The skeletal heights of these sets of skeletons were calculated using the anatomical method of Fully ( Ann. Med. Leg. 35:266-273). Nine parameters of the calcaneus were measured and matched against skeletal heights, using univariate and multivariate regression methods. Regression equations were obtained for estimation of the stature of the South African black population from the calcaneus. The standard error of estimate that was obtained with univariate regression analysis was higher than the corresponding values using multivariate regression analysis. In both cases, the standard errors of estimate compared well with the values obtained for fragmentary long bones by previous authors.American Journal of Physical Anthropology 03/2005; 126(3):335-42. DOI:10.1002/ajpa.20063 · 2.51 Impact Factor
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ABSTRACT: Bohler's angle and the crucial angle of Gissane can be used to assess calcaneal fractures. While the normal adult values of these angles are widely known, the normal paediatric values have not yet been established. Our aim is to investigate Bohler's angle and the crucial angle of Gissane in a paediatric population and establish normal paediatric reference values. We measured Bohler's angle and the crucial angle of Gissane using normal plain ankle radiographs of 763 patients from birth to 14 years of age completed over a five year period from July 2003 to June 2008. In our paediatric study group, the mean Bohler's angle was 35.2 degrees and the mean crucial angle of Gissane was 111.3 degrees. In an adult comparison group, the mean Bohler's angle was 39.2 degrees and the mean crucial angle of Gissane was 113.8 degrees. The differences in Bohler's angle and the crucial angle of Gissane between these two groups were statistically significant. We have presented the normal values of Bohler's angle and the crucial angle of Gissane in a paediatric population. These values may provide a useful comparison to assist with the management of the paediatric calcaneal fracture.Journal of Orthopaedic Surgery and Research 01/2011; 6:2. DOI:10.1186/1749-799X-6-2 · 1.58 Impact Factor