Exploratory 3D-CT Morphometric Study of the Safe Bony Corridor for Percutaneous Navicular Fixation Across Neutral, Cavus, and Planus Foot Phenotypes
11 affiliations
- 1Master Fellow Foot and Ankle Surgery, Universitat de Barcelona, 08007 Barcelona, Spain
- 2School of Medicine, Finis Terrae University, Santiago 7501015, Chile
- 3Foot and Ankle Surgery Unit, Hospital Clínico La Florida, Santiago 8242238, Chile
- 4Foot and Ankle Surgery Unit, Clinica Trinitas and Integramedica a part of Bupa Chile, Santiago 7500000, Chile
- 5Foot and Ankle Surgery Unit, Department of Orthopedics and Traumatology, Hospital Clinic de Barcelona, Universitat de Barcelona, 08007 Barcelona, Spain
- 6Clinical Epidemiology and Research Unit, School of Medicine, Finis Terrae University, Santiago 7501015, Chile
- 73D Surgical Planning Lab, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
- 8Orthopedic Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
- 9Service of Orthopaedics and Traumatology, Department of Surgery, EOC, 6500 Bellinzona, Switzerland
- 10Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), 6900 Lugano, Switzerland
- 11Clinica Ars Medica, Swiss Medical Network, 6929 Gravesano, Switzerland
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.
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BibTeX
@article{ruizriquelme2026exploratory,
title = {{Exploratory 3D-CT Morphometric Study of the Safe Bony Corridor for Percutaneous Navicular Fixation Across Neutral, Cavus, and Planus Foot Phenotypes}},
author = {Pablo Ruiz-Riquelme and Ricardo Vega-Croker and Daniel Poggio-Cano and Magdalena Castro-Cruz and Mireia Gamundi-López and Ferran Fillat-Gomà and Enrique Adrian Testa},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15207796},
url = {https://www.mdpi.com/2077-0383/15/20/7796},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Exploratory 3D-CT Morphometric Study of the Safe Bony Corridor for Percutaneous Navicular Fixation Across Neutral, Cavus, and Planus Foot Phenotypes
AU - Pablo Ruiz-Riquelme
AU - Ricardo Vega-Croker
AU - Daniel Poggio-Cano
AU - Magdalena Castro-Cruz
AU - Mireia Gamundi-López
AU - Ferran Fillat-Gomà
AU - Enrique Adrian Testa
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15207796
UR - https://www.mdpi.com/2077-0383/15/20/7796
AB - 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.
SN - 2077-0383
ER -