Assessment of stress-strain distribution in flatfoot deformity (part 1)
Keywords:foot, flatfoot deformity, arthroeresis, mathematical modeling
In the last decade, there has been an increase in the number of patients of different ages with the pathology of the foot. Thus, the flatfoot, according to different authors, is from 35 to 50 % of the entire pathology of the feet in children and up to 75 % in adults. One of the modern methods of surgical treatment of flatfoot is subtalar arthroesis. However, the researchers did not agree on its effectiveness.
Objective: to study the stress-strain state of the bone elements of the foot in the normal and with flatfoot deformity.
Methods: to solve this problem, a finite-element foot model was constructed, consisting of heel, talus, n avicular a nd s phenoid b ones, a s w ell a s t ibial a nd peroneal fragments. The joint surfaces were modeled by elements with mechanical properties of the cartilaginous tissue.
Results: it is established that for the foot model, the stress intensity in all bone elements is uniformly distributed and has values in the range from 0.1 to 1.7 MPa. The zone of increased stress level is located on the supporting surface of the heel bone, where their maximum value reaches 4.9 MPa. As a result of the study of the model, a stress level was revealed in all bone elements of the foot, especially on the supporting surface of the calcaneus (from 4.9 MPa in the norm to 7.2 MPa) and on the surfaces of the joint, on the scaphoid bone (from 0.6 MPa in the norm to 6.9 MPa with the FFD). The highest concentration of stresses is determined on the posterolateral part of the joint surface of the talus bone — from 1.0 MPa in the norm to 13.5 MPa.Conclusion: the increase and redistribution of stresses in the osteochondrium elements of the foot in case flatfoot deformity can be a trigger mechanism for the development of an unstable ankle joint and arthrosis phenomena in the joints of the foot.
Korzh NA, Yaremenko DA. Acquired deformities of the foot (diagnosis and treatment). Kharkiv: Word, 2014. 136 p. (in Russian)
Lashkowskiy VV, Marmysh AG. Pediatric and adolescent Pediatrics modern approaches to the diagnosis and treatment of the feet diseases. Surgery news. 2011;19(2):94–100. (in Russian)
Korzh NA, Yaremenko DA. Structural-functional features of the foot as the body part of support and movement. Orthopedics, traumatology and prosthetics. 2003(3):36–41. (in Russian)
Lee MS , Vanore JV, Thomas JL, Catanzariti AR, Kogler G, Kravitz SR, Miller SJ, Gassen SC; Clinical Practice Guideline Adult Flatfoot Panel. Diagnosis and treatment of adult flatfoot. J Foot Ankle Surg. 2005;44(2):78–113. doi: 10.1053/j.jfas.2004.12.001.
Pinney SJ, Lin SS. Current concept review: acquired adult flatfoot deformity. Foot Ankle Int. 2006;27(1):66–75. doi: 10.1177/107110070602700113.
Sviridenko AI, Leshkovskiy VV. Biomechanics and correction of foot dysfunctions / under the editorship of Grodno: Kupala Grodno State University, 2009. 279 p. (in Russian)
Vogler HM. Subtalar joint blocking operations for pathological pronation syndromes. Comprehensive Text-book of Foot Surgery. Ed. E. D. McGlamry. Baltimore:Williams & Wilkins, 1987/ pp. 447–65.
Schon LC. Subtalararthroereisis: a new exploration of an old concept. Foot Ankle Clin. 2007;12(2):329–39. doi: 10.1016/j.fcl.2007.03.011.
Patterson RL Jr, Parrish FF, Hathaway EN. Stabilizing operations on the foot: a study of the indications, techniques used, and end results. J Bone Joint Surg. Am. 1950;32-A:1–26.
Westberry DE, Davids JR, Shaver JC, Tanner SL, Blackhurst DW, Davis RB. Impact of ankle-foot orthoses on static foot alignment in children with cerebral palsy. J Bone Joint Surg Am. 2007;89:806–13. doi: 10.2106/JBJS.F.00694.
Zaziriy I, Kovalchuk V, Lyabakh A, Grebenikov K. Supracalcaneal-calcaneal arthroereisis (a review of literature). Orthopedics, traumatology and prosthetics. 2013;(2):98–101. doi: 10.15674/0030-598720132109-113. (in Ukrainian)
Korolkov O, Rakhman P, Kykosh G. Subtalar arthroeresis in the treatment of planovalgus feet deformity: the pros and cons (the review of literature. Orthopedics, traumatology and prosthetics. 2016;(1):115–23. doi: 10.15674/0030-598720161115-123. (in Russian)
Kuhn DR, Shibley NJ, Austin WM, Yochum TR. Radiographic evaluation of weight-bearing orthotics and their effect on flexible pesplanus. J Manipulative Physiol Ther. 1999;22(4):221–6.
.Agapov VP. Finite element method in statics, dynamics and stability of thin-walled spatial supported structures : textbook. Moskow: ASV, 2000. 152 p. (in Russian)
Berezovskiy VA, Kolotilov NN. Biophysical characteristics of human tissues: Handbook. Kyiv: Naukova Dumka, 1990. 224 p. (in Russian)
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