Deformation and stress distribution of the human foot after plantar ligaments release:A cadaveric study and finite element analysis  

作　　者：LIANG Jun YANG YunFeng YU GuangRong NIU WenXin WANG YuBin 

机构地区：[1]Sports Medicine Department of Shanghai East Hospital Tongji University, Shanghai 200120, China [2]Orthopaedic Department of Tongji Hospital, Tongji University, Shanghai 200065, China [3]School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China

出　　处：《Science China(Life Sciences)》2011年第3期267-271,共5页中国科学（生命科学英文版）

基　　金：supported by the National Natural Science Foundation of China(Grant No. 30801163)

摘　　要：The majority of foot deformities are related to arch collapse or instability,especially the longitudinal arch.Although the relationship between the plantar fascia and arch height has been previously investigated,the stress distribution remains unclear.The aim of this study was to explore the role of the plantar ligaments in foot arch biomechanics.We constructed a geometrical detailed three-dimensional (3-D) finite element (FE) model of the human foot and ankle from computer tomography images.The model comprised the majority of joints in the foot as well as bone segments,major ligaments,and plantar soft tissue.Release of the plantar fascia and other ligaments was simulated to evaluate the corresponding biomechanical effects on load distribution of the bony and ligamentous structures.These intrinsic ligaments of the foot arch were sectioned to simulate different pathologic situations of injury to the plantar ligaments,and to explore bone segment displacement and stress distribution.The validity of the 3-D FE model was verified by comparing results with experimentally measured data via the displacement and von Mise stress of each bone segment.Plantar fascia release decreased arch height,but did not cause total collapse of the foot arch.The longitudinal foot arch was lost when all the four major plantar ligaments were sectioned simultaneously.Plantar fascia release was compromised by increased strain applied to the plantar ligaments and intensified stress in the midfoot and metatarsal bones.Load redistribution among the centralized metatarsal bones and focal stress relief at the calcaneal insertion were predicted.The 3-D FE model indicated that plantar fascia release may provide relief of focal stress and associated heel pain.However,these operative procedures may pose a risk to arch stability and clinically may produce dorsolateral midfoot pain.The initial strategy for treating plantar fasciitis should be non-operative.The majority of foot deformities are related to arch collapse or instability,especially the longitudinal arch.Although the relationship between the plantar fascia and arch height has been previously investigated,the stress distribution remains unclear.The aim of this study was to explore the role of the plantar ligaments in foot arch biomechanics.We constructed a geometrical detailed three-dimensional （3-D） finite element （FE） model of the human foot and ankle from computer tomography images.The model comprised the majority of joints in the foot as well as bone segments,major ligaments,and plantar soft tissue.Release of the plantar fascia and other ligaments was simulated to evaluate the corresponding biomechanical effects on load distribution of the bony and ligamentous structures.These intrinsic ligaments of the foot arch were sectioned to simulate different pathologic situations of injury to the plantar ligaments,and to explore bone segment displacement and stress distribution.The validity of the 3-D FE model was verified by comparing results with experimentally measured data via the displacement and von Mise stress of each bone segment.Plantar fascia release decreased arch height,but did not cause total collapse of the foot arch.The longitudinal foot arch was lost when all the four major plantar ligaments were sectioned simultaneously.Plantar fascia release was compromised by increased strain applied to the plantar ligaments and intensified stress in the midfoot and metatarsal bones.Load redistribution among the centralized metatarsal bones and focal stress relief at the calcaneal insertion were predicted.The 3-D FE model indicated that plantar fascia release may provide relief of focal stress and associated heel pain.However,these operative procedures may pose a risk to arch stability and clinically may produce dorsolateral midfoot pain.The initial strategy for treating plantar fasciitis should be non-operative.

关 键 词：BIOMECHANICS finite element analysis foot arch LIGAMENT STRESS 

分 类 号：TQ336.1[化学工程—橡胶工业] TH49[机械工程—机械制造及自动化]