{ "abstract": "Background: The navicular bone is a complex structure with a three-dimensional morphology that varies according to foot phenotype, but has not been completely characterized for safe percutaneous fixation. Objective: The objective of this study was to develop and apply a standardized 3D-CT protocol to identify the navicular safe bony corridor and quantify its dimensions according to foot phenotype and sex differences. Methods: Using an exploratory cross-sectional observational study, we evaluated 63 navicular bones (21 per phenotype: neutral, cavus, planus), selected by stratified random sampling. A pilot phase was first conducted on nine feet (three per phenotype) to establish and refine the measurement protocol; in this phase, measurements were independently performed by two observers, yielding an excellent inter-observer reliability. The remaining 54 feet were then measured by the biomedical engineer. Comparisons between foot phenotypes and sex were performed using Kruskal–Wallis and Dunn’s post hoc tests with a Bonferroni correction (all two-tailed, α = 0.05). Results: The safe bony corridor demonstrated median dimensions of a 38.96 mm length (range: 34.05–47.3 mm), a 10.02 mm diameter (range: 5.84–13.04 mm), and a volume of 3063 mm3 (range: 1135–5614 mm3). There were no differences in the volume among the phenotypes (p = 0.274), although their length differed (p = 0.046). The central corridor angle showed significant variation among the phenotypes (p = 0.010): cavus, 8.02°; neutral, 7.05°; planus, 6.99°. Corridor occupation varied by phenotype: cavus, 30.9%; neutral, 29.0%; planus, 27.2% (p = 0.008). Males demonstrated longer corridors than females (40.14 vs. 37.76 mm, p < 0.001), but a similar diameter (p = 0.085). The safe diameter (2 mm margin) median was 8.02 mm. Conclusions: A standardized and reproducible 3D-CT protocol allows for the precise identification of the safe navicular bony corridor for percutaneous screw fixation with a medial-to-lateral orientation. Although the corridor dimensions remained relatively consistent among phenotypes, the angular and dimensional variability by foot phenotype and sex justifies an individualized preoperative evaluation using 3D-CT to optimize implant selection.", "abstract_shown": true, "affiliations": [ "Master Fellow Foot and Ankle Surgery, Universitat de Barcelona, 08007 Barcelona, Spain", "School of Medicine, Finis Terrae University, Santiago 7501015, Chile", "Foot and Ankle Surgery Unit, Hospital Clínico La Florida, Santiago 8242238, Chile", "Foot and Ankle Surgery Unit, Clinica Trinitas and Integramedica a part of Bupa Chile, Santiago 7500000, Chile", "Foot and Ankle Surgery Unit, Department of Orthopedics and Traumatology, Hospital Clinic de Barcelona, Universitat de Barcelona, 08007 Barcelona, Spain", "Clinical Epidemiology and Research Unit, School of Medicine, Finis Terrae University, Santiago 7501015, Chile", "3D Surgical Planning Lab, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, 08208 Sabadell, Spain", "Orthopedic Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, 08208 Sabadell, Spain", "Service of Orthopaedics and Traumatology, Department of Surgery, EOC, 6500 Bellinzona, Switzerland", "Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), 6900 Lugano, Switzerland", "Clinica Ars Medica, Swiss Medical Network, 6929 Gravesano, Switzerland" ], "article_type": "research article", "arxiv": null, "author_total": 7, "authors": [ { "affs": [ 0, 1, 2, 3 ], "name": "Pablo Ruiz-Riquelme", "orcid": "0000-0002-3293-8189" }, { "affs": [ 0 ], "name": "Ricardo Vega-Croker", "orcid": "0000-0003-1266-9249" }, { "affs": [ 4 ], "name": "Daniel Poggio-Cano", "orcid": "0000-0002-7523-9986" }, { "affs": [ 5 ], "name": "Magdalena Castro-Cruz" }, { "affs": [ 6 ], "name": "Mireia Gamundi-López" }, { "affs": [ 6, 7 ], "name": "Ferran Fillat-Gomà" }, { "affs": [ 0, 8, 9, 10 ], "name": "Enrique Adrian Testa", "orcid": "0000-0001-6153-0011" } ], "bibtex": "https://research.draconitic.com/paper/fc9aga166bsjc.bib", "cited_by": 0, "doi": "10.3390/jcm15207796", "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705147/?tool=EBI", "id": "fc9aga166bsjc", "issns": [ "2077-0383" ], "landing_url": "https://www.mdpi.com/2077-0383/15/20/7796", "language": "eng", "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2732|Foot and Ankle Surgery" ] ], "openalex": "W7221103057", "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705147/pdf/?tool=EBI", "pmcid": "PMC13705147", "pmid": null, "published": "2026-10-01", "publisher": "MDPI AG", "ris": "https://research.draconitic.com/paper/fc9aga166bsjc.ris", "sources": [ { "first_seen": "2026-10-30T12:20:00Z", "native_id": "10.3390/jcm15207796", "source": "crossref", "url": "https://www.mdpi.com/2077-0383/15/20/7796" }, { "first_seen": "2026-10-30T12:21:47Z", "native_id": "PMC:PMC13705147", "source": "europepmc", "url": "https://europepmc.org/article/PMC/PMC13705147" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2732|Foot and Ankle Surgery", "subfield": "surgery" } ], "title": "Exploratory 3D-CT Morphometric Study of the Safe Bony Corridor for Percutaneous Navicular Fixation Across Neutral, Cavus, and Planus Foot Phenotypes", "title_text": "Exploratory 3D-CT Morphometric Study of the Safe Bony Corridor for Percutaneous Navicular Fixation Across Neutral, Cavus, and Planus Foot Phenotypes", "type": "peer-reviewed", "updated_at": "2026-10-30T12:21:47Z", "url": "https://research.draconitic.com/paper/fc9aga166bsjc", "venue": "Journal of Clinical Medicine", "versions": [] }