Finite Element Analysis of Generalized Ligament Laxity on the Deterioration of Hallux Valgus Deformity (Bunion)

Wong, Duo Wai-Chi; Yan, Wang; Chen, Tony Lin-Wei; Yan, Fei; Peng, Yonghan; Tan, Qitao; Ni, Ming; Leung, Aaron Kam Lun; Zhang, Ming

doi:10.3389/fbioe.2020.571192

Cited by 31 publications

(26 citation statements)

References 64 publications

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“…It may require other compensatory strategy involving the hip adopted, resulting in a greater displacement of the centre of pressure in both anteroposterior and mediolateral direction [42]. The potential cause of this abnormal loading pattern is the poor alignment of the transverse tarsal joint and the ligament laxity [18]. A stable joint is linear so that force could transfer along the joint axis and the compression could distributed evenly to the joint surface [40].…”

Section: Discussionmentioning

confidence: 99%

“…Some cadaveric researches found the alterations of mechanical loading such as joint reactive force [16], joints contact pressure [17] to show the implication of foot ligaments by ligament resection. Wong and his fellows [18] found that ligament laxity can result in forefoot abduction and inferred that it may be potentially coupled with pronation and arch collapse. Therefore, fully understanding of the abnormal loading conditions in the foot of the DS children during standing is necessary.…”

Section: Introductionmentioning

confidence: 99%

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Abnormal Biomechanical Conditions of the Foot in Child with Down Syndrome During Standing: A Finite Element Study

Huang

Zhang

et al. 2021

Preprint

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Background: Down syndrome children have a high incidence of pes planus. Pain follows and does harm to their daily life. To well manage their foot pain, it’s necessary to know the mechanism of the pain from the aspect of biomechanics. The purpose of this study was to characterize the abnormal biomechanical conditions of foot in Down syndrome children during standing, comparing to the normal control children by finite element method. Methods: Two participants aged 5 were recruited in this study that are a Down syndrome child with pes planus and a normal control child. Two three-dimension finite element foot models were constructed from CT of the two participants, each of which include bones, ligaments, plantar fascia, cartilages, epiphyseal plates and an encapsulated soft tissue. The plantar pressure during standing and anthropometric data were collected from the same participants for model validation and simulation. Results: The abnormal alignment of the transverse tarsal joint showed in Down syndrome child. The contact pressure in Down syndrome child was higher in tibiotalar joint, compared with the normal control child. The tensile force of spring, plantar calcaneocuboid ligaments in Down syndrome child was approximately 9 folds and 58 folds greater than normal control child, respectively. In Down syndrome child contact force of the talonavicular joint was 0.05 times the body weight and calcaneocuboid joint was near zero, whereas the value in normal control child was 0.11 and 0.01 respectively. Conclusion: The Down syndrome child showed abnormal biomechanical conditions in foot in terms of joints contact pressure, tensile force of ligament around transverse tarsal joint and contact force transmission through transverse tarsal joint. These abnormal biomechanical conditions resulted from pes planus are the potential factors that may cause their foot pain. Conservative interventions should be considered at their early age to eliminate negative effect of these potential factors.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Abnormal Biomechanical Conditions of the Foot in Child with Down Syndrome During Standing: A Finite Element Study

Huang

Zhang

et al. 2021

Preprint

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“…Zhang et al [ 21 ] predicted the metatarsal stress and pressure of a severe HV patient under a balanced standing condition using a comprehensive FE model of the foot and ankle complex. Wong et al [ 22 ] established a musculoskeletal model to explore the effect of ligament relaxation on the etiology of HV. The above studies are all based on the FE method to explore all kinds of foot problems.…”

Section: Introductionmentioning

confidence: 99%

Effect of Displacement Degree of Distal Chevron Osteotomy on Metatarsal Stress: A Finite Element Method

Zhang

Huang

et al. 2022

Biology

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Background: The stress of foot bone can effectively evaluate the functional damage caused by foot deformity and the results of operation. In this study, the finite element method was used to investigate the degree of displacement of distal chevron osteotomy on metatarsal stress and metatarsophalangeal joint load; Methods: Four finite element models of displacement were established by using the CT images of a patient with moderate hallux valgus (hallux valgus angle and intermetatarsal angle were 26.74° and 14.09°, respectively), and the validity of the model was verified. Each finite element model consisted of bones and various cartilage structures, ligaments, and plantar fascia, as well as encapsulated soft tissue. Except for soft tissue, the material properties of other parts were isotropic linear elastic material, and the encapsulated soft tissue was set as nonlinear hyperelastic material. The mesh was tetrahedral mesh. Link elements were used in ligament and plantar fascia. A ground reaction force with a half-body weight was applied at the bottom of the floor to simulate the ground reaction when standing. The upper surfaces of the encapsulated soft tissue, distal tibia, and distal fibula were fixed. The stress distribution of metatarsals and the stress of cartilage of the first metatarsophalangeal joint were compared and analyzed; Results: Compared with the hallux valgus without osteotomy, the stress of the first metatarsals and second metatarsals of 2–4 mm decreased, and the stress of the interarticular cartilage of the first metatarsophalangeal joint with 4 mm was reduced. In the case of 6 mm, the stress value between the first metatarsal and the first metatarsophalangeal joint increased, and 4 mm was the most suitable distance; Conclusions: Compared with the hallux valgus without osteotomy, the stress of the first metatarsals and second metatarsals of 2–4 mm decreased, and the stress of the interarticular cartilage of the first metatarsophalangeal joint with 4 mm was reduced. In the case of 6 mm, the stress value between the first metatarsal and the first metatarsophalangeal joint increased, and 4 mm was the most suitable distance. For the degree of displacement of the distal chevron osteotomy, the postoperative stability and the stress distribution of metatarsal bone should be considered. Factors such as hallux valgus angle, intermetatarsal angle, patient’s age, body weight, and metatarsal width should be considered comprehensively. The factors affecting osteotomy need to be further explored. The degree of displacement of osteotomy can be evaluated by FE method before the operation, and the most suitable distance can be obtained.

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“…Past studies had investigated the biomechanics of hallux valgus deformity using finite element analysis. Wong et al (Wong et al, 2020) developed computational foot model from a mild hallux valgus participant and conducted a gait analysis to derive the simulation of walking. The effect of generalized ligament laxity on the stress pattern of the first ray had been studied.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical evaluation of different hallux valgus treatment with plate fixations using single first metatarsal bone model and musculoskeletal lower extremity model

Shih

Hsu

Lin

et al. 2021

JBSE

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Biomechanical evaluation of different hallux valgus treatmentwith plate fixations using single first metatarsal bone model and musculoskeletal lower extremity model Abstract A numerical approach is one of feasible ways to discover the biomechanics of hallux valgus deformity with various osteotomy and fixation strategies. In the present study, two types of finite element models for analyzing the biomechanical performances of hallux valgus treatment with plate fixations were developed including the single first metatarsal bone model and the musculoskeletal lower extremity model. There are four types of plate fixations that were used to correct the deformity of hallux valgus. The strengths and limitations of both the single first metatarsal bone model and the musculoskeletal lower extremity model were evaluated and discussed. The results revealed that the single metatarsal bone models can be used to quickly predict the biomechanical performances of different hallux valgus treatments. Additionally, the musculoskeletal lower extremity models can be used to predict the biomechanical performances of different hallux valgus treatments under a physiological loading. The plate fixations with the insertion of all locking screws revealed better osteotomy fixation stability and lower risk of the implant failure compared to the other fixations. Additionally, the plate fixations with the insertion of six bone screws had lower risk of the metatarsal bone failure compared to the plate fixations with the insertion of four bone screws. The six holes plate with the insertion of six locking screws was the best treatment among the four treatment strategies. The numerical models and simulation techniques developed in the present study can provide useful information for understanding the biomechanics of hallux valgus treatments.

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Finite Element Analysis of Generalized Ligament Laxity on the Deterioration of Hallux Valgus Deformity (Bunion)

Cited by 31 publications

References 64 publications

Abnormal Biomechanical Conditions of the Foot in Child with Down Syndrome During Standing: A Finite Element Study

Abnormal Biomechanical Conditions of the Foot in Child with Down Syndrome During Standing: A Finite Element Study

Effect of Displacement Degree of Distal Chevron Osteotomy on Metatarsal Stress: A Finite Element Method

Biomechanical evaluation of different hallux valgus treatment with plate fixations using single first metatarsal bone model and musculoskeletal lower extremity model

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