Relationship of Calcaneal Angles with Age, Sex, Side, Height and Body Weight

This study aims to investigate the relationships between Bhler (BA), Gissane (GA), calcaneal inclination (CIA), lateral talocalcaneal (LTCA), and Fowler-Philip (FPA) angles, which play a significant role in the diagnosis of foot deformities and in clinical and surgical decision-making, and age, sex, laterality, body height, and body weight.Additionally, this study aims to establish individualspecific normative reference values.Bilateral weight-bearing lateral foot radiographs (n=850) of 425 individuals (216 males, 209 females; mean age: 45.14 15.82 years) without foot pathology were analyzed.The mean values were BA:30.59 3.5, GA:116.06 4.64, CIA:25.5 3.62, LTCA:44.14 6.87, and FPA:61.44 2.73.There were significant differences compared to measurements reported in other populations.BA, CIA, LTCA, and FPA demonstrated significant differences across age groups (BA: p=0.002;CIA: p<0.001;LTCA: p<0.001;FPA: p<0.001).GA and FPA exhibited significant sex-related differences (GA: p=0.011;FPA: p<0.001).No significant correlation was determined between the angles and side.In males, BA was correlated with height positively (r=0.185,p<0.001), while GA showed a positive correlation (r=0.148,p=0.003) and CIA a negative correlation (r=-0.141,p=0.004) with height in females.Regarding body weight, BA was positively correlated in males (r=0.139,p=0.004), whereas CIA (r=-0.156,p=0.001) and LTCA (r=-0.137,p=0.004) showed negative correlations.In females, LTCA was also correlated with weight negatively (r=-0.193,p<0.001).Given the regression analysis, age was associated with a 0.025 decrease in BA per year (p=0.001).GA was, on average, 1.854 higher in females than in males (p<0.001).Each 1 cm increase in height was related with a 0.075 increase in GA (p=0.001), while each 1 kg increase in body weight was related with decreases of 0.051 in CIA (p<0.001),0.104 in LTCA (p<0.001), and 0.019 in FPA (p=0.024).These findings highlight the necessity of considering age, sex, height, and body weight in addition to population-based reference values when evaluating calcaneal angles.