The association between foot morphological development and bone maturation in children: a cross-sectional study

Area of Science:

• Pediatric orthopedics
• Skeletal maturity assessment
• Foot morphology analysis

Background:

• Accurate pediatric foot development assessment is crucial for clinical interventions.
• Chronological age (CA) is standard but may not reflect individual skeletal maturity.
• Bone age (BA) may offer a more precise measure of growth and development.

Purpose of the Study:

• To investigate the correlation between bone age (BA) and foot morphology in children.
• To compare the predictive power of BA versus CA for pediatric foot development.
• To assess the utility of BA in predicting pediatric flatfoot progression.

Main Methods:

• Retrospective cross-sectional study of 141 healthy children (9-13 years).
• Bone age (BA) assessed using hand-wrist X-rays (China 05 RUS-CHN method).
• 3D foot parameters measured via laser scanning; correlation and PCA analyses performed.

Main Results:

• BA showed stronger correlations with foot length, ankle height, ball width, and girth than CA.
• BA-foot length correlation was higher in males (r=0.722) than females (r=0.572).
• BA had limited association with arch morphology (KY index, arch height); PCA confirmed BA predicts foot size, not arch structure.

Conclusions:

• Bone age (BA) is a superior predictor of pediatric foot size growth compared to chronological age (CA), particularly in males.
• BA has limited utility in assessing the maturation of foot arch morphology.
• Findings suggest BA can enhance clinical foot size predictions, but arch development requires further investigation beyond skeletal maturity.