Experimental modeling and biomechanical measurement of flatfoot deformity
Treatment of the flatfoot requires a quantitative understanding of the biomechanical factor on this common deformity. Seven unembalmed foot-ankle complex specimens were used in this study to model experimental flatfoot deformity by release of plantar fasc
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School of Life Science & Technology, Tongji University, Shanghai, China Orthopaedic Department, Tongji Hospital , Tongji University, Shanghai, China 3 Bioengineering Department, Beihang University, Beijing, China
Abstract — Treatment of the flatfoot requires a quantitative understanding of the biomechanical factor on this common deformity. Seven unembalmed foot-ankle complex specimens were used in this study to model experimental flatfoot deformity by release of plantar fascia, spring ligament, long and short plantar ligaments. Digital speckle correlation method (DSCM) and strain gauges were applied to measure displacements and strains of specimens before and after ligaments resection. Acquired data were compared with each other and statistically analyzed. Results of this experiment showed different appearance of foot-arch according to release of different ligament or complex. Obvious flatfoot deformity appeared only after at least three of the four main ligaments were cut off. Under the condition that four ligaments were completely released, the arch height decreased, longitudinal arch prolonged, forefoot abduced, force in various tissues redistributed, and center of bearing shifted forwards. This method is suitable for constructing experimental model of flatfoot deformity. This study accumulated large amounts of data for further research. Keywords — Flatfoot; Experimental model; Ligament resection; Foot-ankle biomechanics.
I. INTRODUCTION Flatfoot is a common disease, whose main clinical manifestations are plantar medial rotation of talus, decrease in the medial arch height, supination and abduction of the forefoot, even joint and soft tissue lesions, resulting in lower extremity pain, weakness and walking inconvenience [1,2]. Many factors may lead to flatfoot, including insufficiency of posterior tibial tendon, inflammatory joint disease, trauma (Lisfranc joint injuries, fractures of the calcaneus), Charcot foot, Achilles tendon contracture, mid-foot instability, imbalance of foot neuromuscular and so on [2]. Although biomechanical research on flatfoot is in the ascendant, it is hard to construct a good experimental model for this disease, and the knowledge of biomechanical environment under plat foot condition is also insufficient [3]. In light of these problems, this study was to construct an experimental model of the flatfoot by releasing plantar ligaments on cadaver specimens, and compare mechanical parameters of displacement, strain of various foot bones between normal and flat foot in normal standing state.
II. METHODS A. Experiment preparations Seven unembalmed cadaver foot-ankle specimens (median age 41.4, standard deviation 15.8; 4 males and 3 females; 4 left and 3 right side) were collected. Radiograph was taken on them to exclude any osseous pathology of preexisting disease or trauma. The skin and muscles above the ankle joint were detached while kept the ligaments around the ankle intact. Tibia residuals were levered by clinical instrument, fibulas residuals were amputated to 6cm below tibia on
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