Medical Engineering & Physics
Volume 32, Issue 4 , Pages 324-331 , May 2010

Effects of internal stress concentrations in plantar soft-tissue—A preliminary three-dimensional finite element analysis

  • Wen-Ming Chen

      Affiliations

    • Division of Bioengineering, Faculty of Engineering, National University of Singapore, Singapore
    • Equal contribution as first author.
    • ,
  • Taeyong Lee

      Affiliations

    • Division of Bioengineering, Faculty of Engineering, National University of Singapore, Singapore
    • Equal contribution as first author.
    • ,
  • Peter Vee-Sin Lee

      Affiliations

    • Department of Mechanical Engineering, Melbourne School of Engineering, University of Melbourne, Australia
    • ,
  • Jin Woo Lee

      Affiliations

    • Department of Orthopaedic Surgery, Yonsei University, Republic of Korea
    • ,
  • Sung-Jae Lee

      Affiliations

    • Department of Biomedical Engineering, College of Biomedical Science & Engineering, Inje University, 607 O-bang, Gimhae, Gyongnam, 621-749, Republic of Korea
    • Corresponding Author InformationCorresponding author. Tel.: +82 55 320 3452; fax: +82 55 320 3292.

Received 26 October 2009 ,Revised 26 December 2009 ,Accepted 6 January 2010.

References 

  1. Boulton AJ, Vileikyte L, Ragnarson-Tennvall G, Apelqvist J. The global burden of diabetic foot disease. Lancet. 2005;366(9498):1719–1724
  2. Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. 2005;293(2):217–228
  3. Duckworth T, Boulton AJ, Betts RP, Franks CI, Ward JD. Plantar pressure measurements and the prevention of ulceration in the diabetic foot. J Bone Joint Surg Br. 1985;67(1):79–85
  4. Veves A, Murray HJ, Young MJ, Boulton AJ. The risk of foot ulceration in diabetic patients with high foot pressure: a prospective study. Diabetologia. 1992;35(7):660–663
  5. Sarnow MR, Veves A, Giurini JM, Rosenblum BI, Chrzan JS, Habershaw GM. In-shoe foot pressure measurements in diabetic patients with at-risk feet and in healthy subjects. Diabetes Care. 1994;17(9):1002–1006
  6. Stess RM, Jensen SR, Mirmiran R. The role of dynamic plantar pressures in diabetic foot ulcers. Diabetes Care. 1997;20(5):855–858
  7. Giacomozzi C, Martelli F. Peak pressure curve: an effective parameter for early detection of foot functional impairments in diabetic patients. Gait Posture. 2006;23(4):464–470
  8. Alexander IJ, Chao EY, Johnson KA. The assessment of dynamic foot-to-ground contact forces and plantar pressure distribution: a review of the evolution of current techniques and clinical applications. Foot Ankle. 1990;11(3):152–167
  9. Mueller MJ, Hastings M, Commean PK, Smith KE, Pilgram TK, Robertson D, et al. Forefoot structural predictors of plantar pressures during walking in people with diabetes and peripheral neuropathy. J Biomech. 2003;36(7):1009–1017
  10. Morag E, Cavanagh PR. Structural and functional predictors of regional peak pressures under the foot during walking. J Biomech. 1999;32(4):359–370
  11. Brash PD, Foster JE, Vennart W, Daw J, Tooke JE. Magnetic resonance imaging reveals micro-haemorrhage in the feet of diabetic patients with a history of ulceration. Diabet Med. 1996;13(11):973–978
  12. Masson EA, Hay EM, Stockley I, Veves A, Betts RP, Boulton AJ. Abnormal foot pressures alone may not cause ulceration. Diabet Med. 1989;6(5):426–428
  13. Armstrong DG, Peters EJ, Athanasiou KA, Lavery LA. Is there a critical level of plantar foot pressure to identify patients at risk for neuropathic foot ulceration?. J Foot Ankle Surg. 1998;37(4):303–307
  14. Cavanagh PR, Ulbrecht JS, Caputo GM. New developments in the biomechanics of the diabetic foot. Diabetes Metab Res Rev. 2000;16(Suppl. 1):S6–S10
  15. Gooding GA, Stess RM, Graf PM, Moss KM, Louie KS, Grunfeld C. Sonography of the sole of the foot. Evidence for loss of foot pad thickness in diabetes and its relationship to ulceration of the foot. Invest Radiol. 1986;21(1):45–48
  16. Cavanagh PR. Plantar soft tissue thickness during ground contact in walking. J Biomech. 1999;32(6):623–628
  17. Gefen A, Megido-Ravid M, Itzchak Y. In vivo biomechanical behavior of the human heel pad during the stance phase of gait. J Biomech. 2001;34(12):1661–1665
  18. Bus SA, Maas M, Cavanagh PR, Michels RP, Levi M. Plantar fat-pad displacement in neuropathic diabetic patients with toe deformity: a magnetic resonance imaging study. Diabetes Care. 2004;27(10):2376–2381
  19. Lott DJ, Hastings MK, Commean PK, Smith KE, Mueller MJ. Effect of footwear and orthotic devices on stress reduction and soft tissue strain of the neuropathic foot. Clin Biomech. 2007;22(3):352–359[Bristol, Avon]
  20. Ledoux WR, Blevins JJ. The compressive material properties of the plantar soft tissue. J Biomech. 2007;40(13):2975–2981
  21. Yarnitzky G, Yizhar Z, Gefen A. Real-time subject-specific monitoring of internal deformations and stresses in the soft tissues of the foot: a new approach in gait analysis. J Biomech. 2006;39(14):2673–2689
  22. Jacob S, Patil MK. Stress analysis in three-dimensional foot models of normal and diabetic neuropathy. Front Med Biol Eng. 1999;9(3):211–227
  23. Gefen A. Stress analysis of the standing foot following surgical plantar fascia release. J Biomech. 2002;35(5):629–637
  24. Wu L. Nonlinear finite element analysis for musculoskeletal biomechanics of medial and lateral plantar longitudinal arch of Virtual Chinese Human after plantar ligamentous structure failures. Clin Biomech. 2007;22(2):221–229[Bristol, Avon]
  25. Budhabhatti SP, Erdemir A, Petre M, Sferra J, Donley B, Cavanagh PR. Finite element modeling of the first ray of the foot: a tool for the design of interventions. J Biomech Eng. 2007;129(5):750–756
  26. Chen WP, Tang FT, Ju CW. Stress distribution of the foot during mid-stance to push-off in barefoot gait: a 3D finite element analysis. Clin Biomech. 2001;16(7):614–620[Bristol, Avon]
  27. Gefen A, Megido-Ravid M, Itzchak Y, Arcan M. Biomechanical analysis of the three-dimensional foot structure during gait: a basic tool for clinical applications. J Biomech Eng. 2000;122(6):630–639
  28. Athanasiou KA, Liu GT, Lavery LA, Lanctot DR, Schenck RC. Biomechanical topography of human articular cartilage in the first metatarsophalangeal joint. Clin Orthop Relat Res. 1998;348:269–281
  29. Lemmon D, Shiang TY, Hashmi A, Ulbrecht JS, Cavanagh PR. The effect of insoles in therapeutic footwear—a finite element approach. J Biomech. 1997;30(6):615–620
  30. Nakamura S, Crowninshield RD, Cooper RR. An analysis of soft tissue loading in the foot—a preliminary report. Bull Prosthet Res. 1981;10–35:27–34
  31. Siegler S, Block J, Schneck CD. The mechanical characteristics of the collateral ligaments of the human ankle joint. Foot Ankle. 1988;8(5):234–242
  32. Wright DG, Rennels DC. A study of the elastic properties of plantar fascia. J Bone Joint Surg Am. 1964;46:482–492
  33. Cheung JT, Zhang M, Leung AK, Fan YB. Three-dimensional finite element analysis of the foot during standing—a material sensitivity study. J Biomech. 2005;38(5):1045–1054
  34. Zhang M, Mak AF. In vivo friction properties of human skin. Prosthet Orthot Int. 1999;23(2):135–141
  35. Keyak JH, Rossi SA, Jones KA, Skinner HB. Prediction of femoral fracture load using automated finite element modeling. J Biomech. 1998;31(2):125–133
  36. Gefen A. Plantar soft tissue loading under the medial metatarsals in the standing diabetic foot. Med Eng Phys. 2003;25(6):491–499
  37. Bygrave CJ, Betts RP. The plantar tissue thickness in the foot: a new ultrasound technique for loadbearing measurements and a metatarsal head depth study. The Foot. 1992;3(2):71–78
  38. Lemmon D, Cavanagh P. Finite element modelling of plantar pressure beneath the second ray with flexor muscle loading. Clin Biomech. 1997;12(3):S13–S14[Bristol, Avon]
  39. Leardini A, O’Connor JJ, Catani F, Giannini S. The role of the passive structures in the mobility and stability of the human ankle joint: a literature review. Foot Ankle Int. 2000;21(7):602–615
  40. Carlsoeoe S. Influence of frontal and dorsal loads on muscle activity and on the weight distribution in the feet. Acta Orthop Scand. 1964;34:299–309
  41. Weijers RE, Walenkamp GH, van Mameren H, Kessels AG. The relationship of the position of the metatarsal heads and peak plantar pressure. Foot Ankle Int. 2003;24(4):349–353
  42. Delbridge L, Perry P, Marr S, Arnold N, Yue DK, Turtle JR, et al. Limited joint mobility in the diabetic foot: relationship to neuropathic ulceration. Diabet Med. 1988;5(4):333–337
  43. Pham H, Armstrong DG, Harvey C, Harkless LB, Giurini JM, Veves A. Screening techniques to identify people at high risk for diabetic foot ulceration: a prospective multicenter trial. Diabetes Care. 2000;23(5):606–611
  44. Gefen A, Megido-Ravid M, Azariah M, Itzchak Y, Arcan M. Integration of plantar soft tissue stiffness measurements in routine MRI of the diabetic foot. Clin Biomech. 2001;16(10):921–925[Bristol, Avon]
  45. Cavanagh PR, Erdemir A, Petre M. A finite element approach to examine the relationship between plantar pressure and internal stress in the foot. In: Presented at the 54th Annual Meeting of the Orthopaedic Research Society. March 2–5. 2008;
  46. Commean PK, Mueller MJ, Smith KE, Hastings M, Klaesner J, Pilgram T, et al. Reliability and validity of combined imaging and pressures assessment methods for diabetic feet. Arch Phys Med Rehabil. 2002;83(4):497–505
  47. Ferri M, Scharfenberger AV, Goplen G, Daniels TR, Pearce D. Weightbearing CT scan of severe flexible pes planus deformities. Foot Ankle Int. 2008;29(2):199–204
  48. Petre M, Erdemir A, Cavanagh PR. An MRI-compatible foot-loading device for assessment of internal tissue deformation. J Biomech. 2008;41(2):470–474

PII: S1350-4533(10)00002-0

doi: 10.1016/j.medengphy.2010.01.001

Medical Engineering & Physics
Volume 32, Issue 4 , Pages 324-331 , May 2010

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