Calcaneal varus angle change in normal calcaneus: a three-dimensional finite element analysis

Zhang, Xuebin; Wu, Hao; Zhang, Liguo; Zhao, Jitang; Zhang, Yingze

doi:10.1007/s11517-016-1527-4

Cited by 8 publications

(5 citation statements)

References 18 publications

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“…Recovery of the Calcaneal Varus Angle was assessed intraoperatively according to the axial radiographic angle of the foot, described by Zhang et al, 11 that is, the foot is perpendicular to the photographic platform and the X‐ray tube points to the midpoint of the medial and lateral malleolus, then temporarily used Kirschner wire to maintain the fracture position after reduction (Figure 1I ).…”

Section: Methodsmentioning

confidence: 99%

Minimally Invasive Treatment of Inversion Shortening Calcaneal Fractures in the “Out‐In” Position

Li,

Ye,

et al. 2023

Orthopaedic Surgery

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ObjectiveHeel fractures need extensive surgical incisions and are challenging to successfully reposition using traditional prying. The goal of this study is to evaluate the clinical effectiveness of using a Kirschner pin‐guided distractor to treat inversion shortening calcaneal fractures in the “out‐in” position.MethodsA total of 40 data from 37 patients with inversion shortened calcaneal fractures from January 2018 to March 2020 were reviewed. Preoperative lateral and axial X‐rays and 3D CT were taken to assess the fracture type, and minimally invasive internal fixation was performed in the “out‐in” position with distractor repositioning, and intraoperative and postoperative images were taken to assess fracture repositioning and fixation. During the follow‐up period, the postoperative functional recovery status was assessed using the VAS score, AOFAS score, and FAOS score. Paired‐samples t‐test was used for all data comparisons.ResultsAll cases received a mean follow‐up of 28.49 ± 3.25 months, and the mean fracture healing time was 7.84 ± 0.71 weeks. The postoperative images showed well‐fixed fracture repositioning, and calcaneal height, length, width, and inversion angles were significantly improved. At the final follow‐up, the calcaneal height, length, and width recovered from 39.35 ± 4.44mm, 79.35 ± 2.7mm, and 45.75 ± 2.87mm preoperatively to 50.93 ± 3.18mm, 82.23 ± 1.90mm, and 39.67 ± 1.58mm postoperatively (p < 0.001; p < 0.001; p < 0.001). The calcaneus inversion angle restored from 7.73° ± 2.26° to 3.80° ± 1.80° (p < 0.001). Böhler's angle and Gissane's angle improved from 13.13° ± 3.02° and 105.15° ± 8.94° to 27.95° ± 3.41° and 122.85° ± 5.54° (p < 0.001; p < 0.001). No non‐healing fractures, osteomyelitis, or traumatic arthritis were observed.ConclusionMinimally invasive internal fixation with distractor repositioning in the “out‐in” position is effective in the treatment of inversion shortening calcaneal fractures while restoring the anatomy and protecting the soft tissue.

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Section: Methodsmentioning

confidence: 99%

Minimally Invasive Treatment of Inversion Shortening Calcaneal Fractures in the “Out‐In” Position

Li,

Ye,

et al. 2023

Orthopaedic Surgery

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“…In previous studies, for selecting the finite foot element model load size, the value is often taken as half of the subject’s body weight [ 12 , 20 , 21 ]. To improve the realism and accuracy of the finite element model, we performed a bipedal plantar pressure analysis on the volunteer’s foot through the Footwork Pro® (Amcube, France) platform to obtain the average foot pressure on the affected limb and the foot pressure area, and calculated the actual load of the affected foot as 160 N to load the finite element model, considering the influence of the gastrocnemius-fibularis muscle on the accuracy of the finite element model of the stiff clubfoot [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

Biomechanical application of finite elements in the orthopedics of stiff clubfoot

Liu

et al. 2022

BMC Musculoskelet Disord

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Background The purpose of this study was to evaluate the effect of varying the different correction angles of hindfoot osteotomy orthosis on the biomechanical changes of the adjacent joints after triple arthrodesis in adult patients with stiff clubfoot to determine the optimal hindfoot correction angle and provide a biomechanical basis for the correction of hindfoot deformity in patients with stiff clubfoot. Methods A 26-year-old male patient with a stiff left clubfoot was selected for the study, and his ankle and foot were scanned using dual-source computed tomography. A three-dimensional finite element model of the ankle was established, and after the validity of the model was verified by plantar pressure experiments, triple arthrodesis was simulated to analyze the biomechanical changes of the adjacent joints under the same load with “3°” of posterior varus, “0°” of a neutral position and “3°, 6°, 9°” of valgus as the correction angles. Results The peak plantar pressure calculated by the finite element model of the clubfoot was in good agreement with the actual plantar pressure measurements, with an error of less than 1%. In triple arthrodesis, the peak von Mises stress in the adjacent articular cartilage was significantly different and less than the preoperative stress when the corrected angle of the hindfoot was valgus “6°”. In comparison, the peak von Mises stress in the adjacent articular cartilage was not significantly different in varus “3°”, neutral “0°”, valgus “3°” and valgus “9°” compared with the preoperative stress. Conclusion The results of this study showed that different angles of hindfoot correction in triple arthrodesis did not increase the peak von Mises stress in the adjacent joints, which may not lead to the development of arthritis in the adjacent joint, and a hindfoot correction angle of “6°” of valgus significantly reduced the peak von Mises stress in the adjacent joints after triple arthrodesis.

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“…Previous studies conducted for the measurement of 3D kinematics of the foot bones during gait can be classified into four categories [1][2][3][4][5][6][7][8][9][10], including skin marker-based motion capture system, fluoroscopy study, in vivo measurement with bone pins, and measurement through cadaver gait simulators. However, some limitations are found in previous research methods.…”

Section: Introductionmentioning

confidence: 99%

In vitro study of foot bone kinematics via a custom-made cadaveric gait simulator

et al. 2020

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Background: Quantifying detailed kinematics of the intrinsic foot bone during gait is crucial for understanding biomechanical functions of the foot complex musculoskeletal structure and making appropriate surgery decisions. Research question: The purpose of this experiment is to measure bone kinematic of the normal foot in a gait cycle via a custom-made cadaveric gait simulator. Methods: In this experiment, we used a custom-made 6 degrees of freedom (DOF) of robotic gait simulator simulating normal human gait to measure the 3-dimensional (3D) kinematics of tibia, calcaneus, cuboid, navicular, medial cuneiform, first metatarsal, and fifth metatarsal through six cadaveric feet. Results: The results showed that the kinematic of the intrinsic foot bones in the stance phase of the gait was successfully quantified using a custom-made robotic gait simulator. During walking stance, the joints in the medial column of foot had less movement than those in the lateral column. And during the later portion of stance, no rotational cease was observed in the movement between navicular and cuboid, calcaneocuboid joint, or cuneonavicular joint. Conclusion: This study described foot bone motion using a biomechanically near-physiological gait simulator with 6 DOF of the tibia. The kinematic data helps to clarify previous descriptions of several joint kinematics that are difficult to study in vivo. The methodology also provides a platform for researchers to explore more invasive foot biomechanics under dynamic and near-physiologic conditions.

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Calcaneal varus angle change in normal calcaneus: a three-dimensional finite element analysis

Cited by 8 publications

References 18 publications

Minimally Invasive Treatment of Inversion Shortening Calcaneal Fractures in the “Out‐In” Position

Minimally Invasive Treatment of Inversion Shortening Calcaneal Fractures in the “Out‐In” Position

Biomechanical application of finite elements in the orthopedics of stiff clubfoot

In vitro study of foot bone kinematics via a custom-made cadaveric gait simulator

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