Pralong-Guanziroli Nastassia, Cochard Blaise, Gurbanov Elvin, Tabard-Fougère Anne, Gavira Nathaly, Valisena Silvia, Dayer Romain, Ceroni Dimitri
Pediatric Orthopaedic Unit, Pediatric Surgery Service, Geneva University Hospitals, Geneva, Switzerland.
Division of Orthopaedic and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland.
J Bone Joint Surg Am. 2025 May 16;107(14):1604-1610. doi: 10.2106/JBJS.24.01096.
The calcaneonavicular distance has yet to be definitively defined on the basis of morphological studies and thus remains a somewhat elusive value for orthopaedists. The purposes of the present study were to measure the calcaneonavicular distance with use of magnetic resonance imaging (MRI) in a control pediatric population and to assess whether sex and age affected this distance.
We retrospectively reviewed 363 MRI scans of the feet of healthy controls and measured calcaneonavicular distances (i.e., the distance between the bone margins of the anterior process of the calcaneus and the navicular and the distance between the cartilaginous margins of the anterior process of the calcaneus and the navicular) in the axial and sagittal planes.
Interobserver and intraobserver agreements were better for the bone measurements than for the cartilaginous measurements. The mean calcaneonavicular distance was 5.6 mm for values based on bone margins and 4.5 mm for those based on cartilaginous margins. On the basis of current criteria, the distributions of these distances were such that 41% to 46% of participants presented with values that defined them as having a too-long anterior process of the calcaneus. Furthermore, age seemed to play a major role in males, with calcaneonavicular distances narrowing with bone maturation.
The mean physiological calcaneonavicular distances measured in healthy pediatric controls are much shorter than reported previously. In almost 50% of cases, the calcaneonavicular distance measurements between the bone margins presented values that defined them as having a too-long anterior process of the calcaneus. Age played a major role in the calcaneonavicular distances in males, and we hypothesize that the calcaneonavicular distance narrows with bone maturation. We believe that it is essential to establish normative calcaneonavicular distance values based on sex and age so that they can be used as guidelines when diagnosing and treating patients suspected of having a too-long anterior process of the calcaneus.
Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.
跟舟间距尚未在形态学研究的基础上得到明确界定，因此对于骨科医生来说，它仍然是一个有些难以捉摸的值。本研究的目的是在对照儿科人群中使用磁共振成像（MRI）测量跟舟间距，并评估性别和年龄是否会影响该间距。
我们回顾性分析了363例健康对照者足部的MRI扫描图像，在轴向和矢状面测量跟舟间距（即跟骨前突与舟骨的骨边缘之间的距离以及跟骨前突与舟骨的软骨边缘之间的距离）。
观察者间和观察者内对于骨测量的一致性优于软骨测量。基于骨边缘的值的平均跟舟间距为5.6毫米，基于软骨边缘的值为4.5毫米。根据当前标准，这些间距的分布情况是，41%至46%的参与者的值表明他们的跟骨前突过长。此外，年龄在男性中似乎起主要作用，随着骨骼成熟，跟舟间距变窄。
在健康儿科对照者中测量的平均生理性跟舟间距比之前报道的要短得多。在近50%的病例中，骨边缘之间的跟舟间距测量值表明他们的跟骨前突过长。年龄在男性跟舟间距中起主要作用，我们推测跟舟间距随着骨骼成熟而变窄。我们认为，有必要根据性别和年龄建立跟舟间距的标准值，以便在诊断和治疗疑似跟骨前突过长的患者时用作指导。
预后水平III。有关证据水平的完整描述，请参阅作者须知。
