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Associations between changes in loading pattern, deformity, and internal stresses at the foot with hammer toe during walking; a finite element approach

Moayedi, M.; Arshi, A.R.; Salehi, M.; Akrami, M.; Naemi, Roozbeh

Associations between changes in loading pattern, deformity, and internal stresses at the foot with hammer toe during walking; a finite element approach Thumbnail


Authors

M. Moayedi

A.R. Arshi

M. Salehi

M. Akrami



Abstract

Over the past decade, Finite Element (FE) modelling has been used as a method to understand the internal stresses within the diabetic foot. Foot deformities such as hammer toe have been associated with increased risk of foot ulcers in diabetic patients. Hence the aim of this study is to investigate the influence of hammer toe deformity on internal stresses during walking. A 3D finite element model of the human foot was constructed based on capturing Magnetic Resonance Imaging (MRI) of a diabetic neuropathic volunteer exhibiting hammer toe. 3D gait measurements and a multi-body musculoskeletal model for the same participant were used to define muscle forces. FE simulations were run at five different instances during the stance phase of gait. Peak plantar pressure and pressure distribution results calculated from the model showed a good agreement with the experimental measurement having less than 11% errors. Maximum von Mises internal stresses in the forefoot hard tissue were observed at the 3rd and 5th metatarsals and 4th proximal phalanx. Moreover, presence of hammer toe deformity was found to shift the location of maximum internal stresses on the soft tissue to the forefoot by changing the location of centre of pressure with internal stress 1.64 times greater than plantar pressure. Hammer toe deformity also showed to reduce the involvement of the first phalanx in internal/external load-bearing during walking. The findings of this study support the association between changes in loading pattern, deformity, and internal stresses in the soft tissue that lead to foot ulceration.

Citation

Moayedi, M., Arshi, A., Salehi, M., Akrami, M., & Naemi, R. (2021). Associations between changes in loading pattern, deformity, and internal stresses at the foot with hammer toe during walking; a finite element approach. Computers in Biology and Medicine, 135, https://doi.org/10.1016/j.compbiomed.2021.104598

Journal Article Type Article
Acceptance Date Jun 18, 2021
Online Publication Date Jun 22, 2021
Publication Date Jul 30, 2021
Deposit Date Aug 21, 2024
Publicly Available Date Aug 30, 2024
Journal Computers in Biology and Medicine
Print ISSN 0010-4825
Electronic ISSN 1879-0534
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 135
DOI https://doi.org/10.1016/j.compbiomed.2021.104598