Sports Medicine: Just the Facts

• Normal angle opens laterally.
  •Parallel or medial opening associated with patellar
  subluxation/dislocation.

FOOT AND ANKLE

BOHLER’SANGLE

• Lateral foot or ankle.


• Angle formed by the intersection of a line drawn from
  posterosuperior margin of the calcaneal tuberosity
  and a line drawn from the tip of the posterior facet
  through the superior margin of the anterior process of
  the calcaneus.


• Used in evaluation of possible calcaneal fractures.


• Normal: 20–40°

GISSANE’SANGLE

• Lateral foot or ankle.


• Angle of the articulation of the talus and calcaneus.


• Used in evaluation of possible calcaneal fractures with
  subsequent subtalar instability.


• Normal: 120–145°.

INTERMETATARSALANGLE

• AP foot.


• Line drawn through axis of 1st and 2nd metatarsals.


• Normal: <9°


• If >15° and correcting hallux valgus, proximal
  metatarsal osteotomy may be required.

FIRSTMETATARSALANGLE

• AP foot.


• Line drawn through axis of 1st metatarsal and proxi-
  mal phalanx.


• Normal: <20°


• Increased in hallux valgus.

AP TALOCALCANEALANGLE(KITE’SAP ANGLE)

• AP foot.


• Longitudinal axis of talus and longitudinal axis of cal-
  caneus.


• Normal: 20–40°


• Decreased in clubfoot and hindfoot varus.

ANTERIORDRAWERSTRESSRADIOGRAPH

• Anterior ankle drawer is performed by the examiner.


• Radiograph is taken during stressof the anterior drawer.


• Comparison is made with unaffected ankle.
  
  
  • Measure the shortest distance between the talar dome
    and the posterior margin of the tibial articular surface.
  
  
  • Anterior translation >8 mm or 5 mm greater than the
    unaffected side.
  
  
  
  

TALARTILTSTRESSRADIOGRAPH

•Talar tilt is performed by the examiner.

• Radiograph is taken during stress of the talar tilt.


• Comparison is made with unaffected ankle.


• Angle is measured between two lines drawn along
  tibial plafond and talar dome.


• Normal is <15°or a difference of <10°when com-
  pared to the normal size.

BIBLIOGRAPHY

Casillas MM: Ligament injuries of the foot and ankle in adult ath-

letes, in DeLee JC, Drez D, Miller MD (eds.): DeLee and

Drez’s Orthopaedic Sports Medicine Principles and Practice,

2nd ed. Philadelphia, PA, Saunders, 2003.

Coughlin MJ: Conditions of the forefoot, in DeLee JC, Drez D,

Miller MD (eds.): DeLee and Drez’s Orthopaedic Sports

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McAlindon, Robert J: On field evaluation and management of

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