Plantar heel pain is a commonly encountered orthopedic problem and is most often caused by plantar fasciitis. In recent years, different shapes of insole have been used to treat plantar fasciitis. However, little research has been focused on the junction stress between the plantar fascia and the calcaneus when wearing different shapes of insole. Therefore, this study aimed to employ a finite element (FE) method to investigate the relationship between different shapes of insole and the junction stress, and accordingly design an optimal insole to lower fascia stress.A detailed 3D foot FE model was created using ANSYS 9.0 software. The FE model calculation was compared to the Pedar device measurements to validate the FE model. After the FE model validation, this study conducted parametric analysis of six different insoles and used optimization analysis to determine the optimal insole which minimized the junction stress between plantar fascia and calcaneus. This FE analysis found that the plantar fascia stress and peak pressure when using the optimal insole were lower by 14% and 38.9%, respectively, than those when using the flat insole. In addition, the stress variation in plantar fascia was associated with the different shapes of insole.

Clinically, different foot arch heights are associated with different tissue injuries to the foot. To investigate the possible factors contributing to the difference in foot arch heights, previous studies have mostly measured foot pressure in either low-arched or high-arched feet. However, little information exists on stress variation inside the foot with different arch heights. Therefore, this study aimed to implement the finite element (FE) method to analyse the influence of different foot arches. This study established a 3D foot FE model using software ANSYS 11.0. After validating the FE model, this study created low-arched, high-arched and normal-arched foot FE models. The FE analysis found that both the stress and strain on the plantar fascia and metatarsal were higher in the high-arched foot, whereas the stress and strain on the calcaneous, navicular and cuboid were higher in low-arched foot. Additionally, forefoot pressure was increased with an increase in arch height.

When treating lateral epicondylitis, botulinum toxin was superior to placebo and could last for 16 weeks. Corticosteroid and botulinum toxin injections were largely equivalent, except the corticosteroid injections were better at pain relief in the early stages and were associated with less weakness in grip in the first 12 weeks.

Calcaneal fractures are the most common fractures of the tarsal bones. The stability of fixation is an important factor for successful reconstruction of calcaneal fractures. The purpose of this study was to analyze the biomechanical influence of plate fixation with different combinations of locking and nonlocking screws during early weight-bearing phase. A three-dimensional FE foot model was established using ANSYS software, which comprised bones, cartilages, plantar fascia, and soft tissue. Calcaneal plate was fixed with whole locking (WLS), whole nonlocking (WNS), and hybrid screw configurations for FE analysis. The WNS generated a 6.1° and 2.2° Bohler angle decrease compared with the intact model and WLS (WNS: 18.9; WLS: 21.1; intact: 25.0°). Some hybrid screw configurations (Bohler angle: 21.5° and 21.2°) generated stability similar to WLS. The FE results showed that the fragments at the posterior facet and the posterior tuberosity sustained more stress. This study recommends that the hybrid screw configuration with at least four locking screws, two at the posterior facet fragment and two at the posterior tuberosity fragment, is the optimal choice for the fixation of Sanders type IIB calcaneal fractures.

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