Paul Sathish, Vijayakumar Rekha, Mathew Lazar, Sivarasu Sudesh
1 SIHR & LC Hospital, Vellore, India.
2 VIT University, Vellore, India.
Prosthet Orthot Int. 2017 Apr;41(2):157-163. doi: 10.1177/0309364616631344. Epub 2016 Jul 9.
The subtalar joint position during static stance is a crucial determinant of the peak plantar pressures and forms ideal reference point for any intervention in foot-related problems for leprosy-affected patients.
The study pursued the hypothesis through a three-dimensional model that stress will be minimal in the distal joints of the foot when the subtalar joint is in neutral static stance position.
Finite element model.
The computed tomography images of the feet for five patients suffering from Hansen's disease having no muscle weakness and joint restriction were acquired. The gray intensities corresponding to the bones of the foot from the computed tomography images were three-dimensionally reconstructed. The three-dimensional model of the human foot, incorporating the realistic geometry, and the material properties of the hard tissues were then analyzed using a finite element solver for the stress distribution on bones of the foot.
The results demonstrate that the position of the calcaneum in the static stance position does contribute to the varying stress in the foot.
The stresses in the bones of the foot are minimal while the subtalar is in neutral position; this position will be suitable for foot orthotic fabrication. Clinical relevance The clinicians, therapists, and podiatrists having less engineering skills can quickly assess the patient and get optimal results on the stress associated with the joints of the foot.
静态站立时距下关节的位置是足底压力峰值的关键决定因素，也是麻风病患者足部相关问题任何干预措施的理想参考点。
本研究通过三维模型验证了一个假设，即当距下关节处于中立静态站立位置时，足部远端关节的应力将最小。
有限元模型。
获取了5例无肌肉无力和关节受限的汉森病患者足部的计算机断层扫描图像。对计算机断层扫描图像中与足部骨骼对应的灰度强度进行三维重建。然后使用有限元求解器分析包含真实几何形状和硬组织材料特性的人足三维模型，以研究足部骨骼上的应力分布。
结果表明，跟骨在静态站立位置的情况确实会导致足部应力变化。
当距下关节处于中立位置时，足部骨骼的应力最小；此位置将适合制作足部矫形器。临床意义 工程技能较低的临床医生、治疗师和足病医生可以快速评估患者，并在与足部关节相关的应力方面获得最佳结果。
