Finite element modeling of diabetic foot: a state-of-the-art review

Abstract

Diabetic foot complications are a widespread issue that causes significant medical, economic, and social burdens for individuals and their families worldwide. Neuropathy often leads to foot ulceration, which is a prevalent consequence of diabetes. Diabetic foot ulcers are commonly diagnosed and pose challenging consequences due to their morbidity, increased risk of lower limb amputation, and related mortality. In recent years, researchers have increasingly used finite element (FE) analysis to simulate the biomechanics of diabetic foot. The primary objective of these simulations is to estimate the mechanical loading conditions for healthy and diseased foot and provide insights into novel interventions such as insole designs, surgical procedures, etc. This paper presents a state-of-the-art review of the literature on finite element modeling and analysis of diabetic foot, focusing on computationally accurate foot modeling, ulcer modeling, and simulation-based management. This review aims to provide researchers a concise description of FE modeling research on diabetic foot while highlighting their potential for future advancements. The summarized literature will be helpful for the development of suitable interventions such as insoles, footwear, and orthotics for the management of diabetic foot pre- and post- ulceration.