Skip to main content
SpringerLink
Log in

Navicular index for differentiation of flatfoot from normal foot

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

The height of navicular bone from the floor is in proportion with the height of longitudinal arch of the foot. The study was conducted to evaluate correlation of navicular bone height with most often used angles, heel valgus and a foot print in order to simplify the procedure for the diagnosis of flatfoot.

Methods

A total of 218 operated children (436 feet) because of flexible flatfoot were evaluated clinically and radiologically. Meary angle, lateral talonavicular angle, talocalcaneal angle, calcaneal pitch, heel valgus and arch index (Staheli) were evaluated pre-operatively and postoperatively. In 121 (242 feet) chosen children (age eight to 15) with all clinical values and pre-operative angles corresponding flatfoot, all postoperatively measured values were within the normal range. We got the navicular index by dividing length of longitudinal arch with navicular height. Values of navicular index were then compared with pre-operatively and postoperatively measured values. Pearson correlation and ROC test were used for statistical analysis.

Results

Values of the navicular index for flatfeet were in the interval from 4.75 to 31.2 (median 8.98), and for normal-arched feet 3.58–22.6 (median 5.48). Pearson correlation of arch index and measured parameters were significant in majority, and degree according to Colton was good. Area under the ROC curve was 0.861 (p = 0.0001). The cut-off value with 86 % sensitivity and 75 % specificity was 6.7407.

Conclusion

Navicular index can be used reliably, without measures of the other parameters, to differentiate flatfoot from normal-arched foot. Therefore, the navicular index has an ability to distinguish between the flatfoot and normal-arched foot.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Lovett HW, Dane J (1896) The affections of the arch of the foot commonly classified as flat-foot. J Bone Joint Surg Am s1–8:78–92.

    Google Scholar 

  2. Pauk J, Griskevicius J (2011) Ground reaction force and support moment in typical and flat-feet children. Mechanika 17:93–96

    Article  Google Scholar 

  3. Foot Health Facts. The official consumer website of American College of Foot and Ankle Surgeons™. http://www.foothealthfacts.org/footankleinfo/pediatric-flatfoot.htm (accessed 30/09/2012).

  4. Trott AW (1982) Children’s foot problems. Orthop Clin North Am 13:641–654

    PubMed  CAS  Google Scholar 

  5. Caselli MA, Sobel E, McHale KA (1998) Pedal manifestations of musculoskeletal disease in children. Clin Podiatr Med Surg 15:481–497

    PubMed  CAS  Google Scholar 

  6. Harris EJ (2000) The oblique talus deformity. What is it, and what is its clinical significance in the scheme of pronatory deformities? Clin Podiatr Med Surg 17:419–442

    PubMed  CAS  Google Scholar 

  7. Hefti F (1999) Foot pain. Orthopade 28(2):173–179

    PubMed  CAS  Google Scholar 

  8. Kumar SJ, Cowell HR, Ramsey PL (1985) Foot problems in children. Part 1. Vertical and oblique talus. Instr Course Lect 31:235–251

    Google Scholar 

  9. Kumar SJ, Ramsey PL (1977) Vertical and oblique talus (a diagnostic dilemma). Orthop Trans 1:108

    Google Scholar 

  10. Sullivan JA (1999) Pediatric flatfoot (evaluation and management). J Am Acad Orthop Surg 7:44–53

    PubMed  CAS  Google Scholar 

  11. Tonnis D (1986) Skewfoot. Orthopade 15:174–183

    PubMed  CAS  Google Scholar 

  12. Harris EJ, Vanore JV, Thomas JL et al (2004) Diagnosis and treatment of pediatric flatfoot. J Foot Ankle Surg 43:341–373

    Article  PubMed  Google Scholar 

  13. Roth S, Sestan B, Tudor A, Ostojic Z, Sasso A, Durbesic A (2007) Minimally invasive calcaneo-stop method for idiopathic, flexible pes planovalgus in children. Foot Ankle Int 28(9):991–995

    Article  PubMed  Google Scholar 

  14. Roth S (2007) Minimal invasive calcaneo-stop method in cases of pes planovalgus in childhood with “BoneStar®” implant. J Child Orthop 1(suppl 1):25

    Google Scholar 

  15. Roth S, Durbesic A, Bajok I (2011) Treatment of the flexible flatfoot in children with the modified calcaneo-stop method with BoneStar® implant. J Child Orthop 5(suppl 1):S1–S35

    Google Scholar 

  16. Kellermann P, Roth S, Gion K, Boda K, Tóth K (2011) Calcaneo-stop procedure for paediatric flexible flatfoot. Arch Orthop Trauma Surg 131(10):1363–1367

    Article  PubMed  Google Scholar 

  17. Gillham EM (2001) A life of Sir Francis Galton: from African exploration to the birth of Eugenics, 1st edn. Oxford University Press, Oxford, p 432

    Google Scholar 

  18. Colton T (1974) Statistics in medicine, 1st edn. Little: Brown & Company, Boston, pp 372

  19. Zhou XH, McClish DK, Obuchowski NA (2011) Statistical methods in diagnostic medicine, 2nd edn. Wiley, New York, p 545

    Book  Google Scholar 

  20. DeLong ER, DeLong DM, Clarke-Pearson DL (1988) Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 44:837–845

    Article  PubMed  CAS  Google Scholar 

  21. Williams DS, McClay IS (2000) Measurements used to characterize the foot and the medial longitudinal arch: reliability and validity. Phys Ther 80:864–871

    PubMed  CAS  Google Scholar 

  22. Shrader JA, Popovich JM Jr, Gracey GC et al (2005) Navicular drop measurement in people with rheumatoid arthritis: interrater and intrarater reliability. Phys Ther 85:656–664

    PubMed  Google Scholar 

  23. Murley GS, Menz HB, Landorf KB (2009) A protocol for classifying normal- and flat-arched foot posture for research studies using clinical and radiographic measurements. J Foot Ankle Res 2:22

    Article  PubMed  Google Scholar 

  24. Graham ME, Jawrani NT, Chikka A (2011) Radiographic evaluation of navicular position in the sagittal plane-correction following an extraosseous talotarsal stabilization procedure. J Foot Ankle Surg 50:551–557

    Article  PubMed  Google Scholar 

  25. Cornwall MW, Mc Poil TG (1999) Relative movement of the navicular bone during normal walking. Foot Ankle Int 20:507–512

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest statement

All authors disclose any potential conflicts of interest, including specific financial interests relevant to the subject of their manuscript.

Competing interests

None.

Funding

This work was supported by grants from the Primorsko-goranska County of the Republic of Croatia.

Ethics approval

The study was approved by the Medical ethics committees of the Clinical Hospital Center Rijeka, and School of Medicine, University of Rijeka, Croatia.

Author information

Authors and Affiliations

  1. KBC Rijeka, Orthopaedics, Rijeka, Croatia

    Sandor Roth

  2. School of Medicine, University of Rijeka, Rijeka, Croatia

    Aron Roth, Zdravko Jotanovic & Tomislav Madarevic

  3. University Hospital for Orthopaedic Surgery Lovran, Rijeka, Croatia

    Zdravko Jotanovic & Tomislav Madarevic

Authors
  1. Sandor Roth
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Aron Roth
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zdravko Jotanovic
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tomislav Madarevic
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sandor Roth.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Roth, S., Roth, A., Jotanovic, Z. et al. Navicular index for differentiation of flatfoot from normal foot. International Orthopaedics (SICOT) 37, 1107–1112 (2013). https://doi.org/10.1007/s00264-013-1885-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-013-1885-6

Keywords

Search

Navigation