REGIONAL AND GENDER-BASED NORMATIVE VALUES OF THE TALOCALCANEAL ANGLE IN AN AFRICAN POPULATION
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Abstract
Background: The talocalcaneal angle (TCA) is an important radiographic parameter used to evaluate hindfoot alignment and diagnose various foot deformities. While extensive data exist for non-African populations, research on normal TCA ranges for African populations remains limited, despite their importance for region-specific diagnostic and surgical planning.
Objective: This study aimed to establish a nomogram for the TCA in an African population, evaluating potential gender and age differences and comparing findings with non-African studies.
Methods: A prospective cross-sectional study was conducted with 120 participants (60 males, 60 females) aged 19–70 years. Standardized lateral weightbearing foot radiographs were obtained following clinical examination to exclude pathological conditions. The TCA was measured three times by two independent raters, and the intraclass correlation coefficient (ICC) was used to assess inter- and intra-rater reliability. Statistical analyses, including independent t-tests and ANOVA, were performed to evaluate gender and age effects.
Results: The mean ± 2SD TCA was 39.20 ± 6.76 degrees, with a normal range of 32.44 to 45.96 degrees. No significant differences were observed between genders or across age groups (p > 0.05). ICC analysis demonstrated excellent reliability for averaged measures (p < 0.001). The TCA was significantly higher than reported values in non-African populations (p < 0.05).
Conclusion: This study provides a population-specific normal range for TCA in an African cohort, emphasizing the importance of regional norms for clinical and surgical decision-making. Future research should explore factors influencing TCA and validate these findings across diverse African populations.
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References
1. Carrara C, Caravaggi P, Belvedere C, Leardini A. Radiographic angular measurements of the foot and ankle in weight-bearing: A literature review. Foot Ankle Surg. 2020 Jul;26(5):509–17.
2. Masquijo JJ, Tourn D, Torres-Gomez A. Fiabilidad del ángulo astrágalo-calcáneo para la evaluación de la alineación del retropié. Rev Esp Cir Ortopédica Traumatol. 2019 Jan;63(1):20–3.
3. Deniz G, Kaya A, Ercan Z, Kavakli A, Ogeturk M. The Evaluation of Radiologic Angular Measurements in Patients with Foot Pain. J Am Podiatr Med Assoc. 2020 Jul 1;110(4):Article_8.
4. Moraleda L, Gantsoudes GD, Mubarak SJ. C sign: Talocalcaneal Coalition or Flatfoot Deformity? J Pediatr Orthop. 2014 Dec;34(8):814–9.
5. Lamm BM, Stasko PA, Gesheff MG, Bhave A. Normal Foot and Ankle Radiographic Angles, Measurements, and Reference Points. J Foot Ankle Surg. 2016 Sep;55(5):991–8.
6. Saltzman CL, Brandser EA, Berbaum KS, DeGnore L, Holmes JR, Katcherian DA, et al. Reliability of Standard Foot Radiographic Measurements. Foot Ankle Int. 1994 Dec;15(12):661–5.
7. Didia B, Dimkpa J. The calcaneal angle in Nigerians. Relationship to sex, age, and side of the body. J Am Podiatr Med Assoc. 1999 Sep 1;89(9):472–4.
8. Dahiru AU, Ojo SA, Hamidu AU, Danborno B. Calcaneal Pitch and Lateral Talocalcaneal Angle among Nigerians. Int J Morphol. 2013 Jun;31(2):528–32.
9. Igbigbi PS, Mutesasira AN. Calcaneal angle in Ugandans. Clin Anat. 2003 Jun;16(4):328–30.
10. Katchy A, Njeze N, Okoroafor D. Morphometric analysis of calcaneal angles in Igbos of south east of Nigeria and its clinical implication: A plain x-ray study. Niger J Orthop Trauma. 2018 Jan;17:64.
11. Thomas JL, Kunkel MW, Lopez R, Sparks D. Radiographic Values of the Adult Foot in a Standardized Population. J Foot Ankle Surg. 2006 Jan;45(1):3–12.
12. Meyr AJ, Wagoner MR. Descriptive Quantitative Analysis of Rearfoot Alignment Radiographic Parameters. J Foot Ankle Surg. 2015 Sep;54(5):860–71.
13. Zheng W, Du J, Lu Y, Liang J, Zhang Y, Liang X, et al. Analysis of Normal Ankle Radiographic Angles [Internet]. In Review; 2020 [cited 2024 Nov 10]. Available from: https://www.researchsquare.com/article/rs-34939/v1
14. Shoukry FA, Aref YK, Sabry AAE. Evaluation of the normal calcaneal angles in Egyptian population. Alex J Med. 2012 Jun 1;48(2):91–7.