Biomechanical study of tarsometatarsal joint fusion using finite element analysis.
Complications of surgeries in foot and ankle bring patients with severe sufferings. Sufficient understanding of the internal biomechanical information such as stress distribution, contact pressure, and deformation is critical to estimate the effectiveness of surgical treatments and avoid complications. Foot and ankle is an intricate and synergetic system, and localized intervention may alter the functions to the adjacent components. The aim of this study was to estimate biomechanical effects of the TMT joint fusion using comprehensive finite element (FE) analysis. A foot and ankle model consists of 28 bones, 72 ligaments, and plantar fascia with soft tissues embracing all the segments. Kinematic information and ground reaction force during gait were obtained from motion analysis. Three gait instants namely the first peak, second peak and mid-stance were simulated in a normal foot and a foot with TMT joint fusion. It was found that contact pressure on plantar foot increased by 0.42%, 19% and 37%, respectively after TMT fusion compared with normal foot walking. Navico-cuneiform and fifth meta-cuboid joints sustained 27% and 40% increase in contact pressure at second peak, implying potential risk of joint problems such as arthritis. Von Mises stress in the second metatarsal bone increased by 22% at midstance, making it susceptible to stress fracture. This study provides biomechanical information for understanding the possible consequences of TMT joint fusion.
Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China; The Hong Kong Polytechnic University Shenzhen Research Institute, Hong Kong, China.
Yan
Y
Wang
Key Laboratory of High Efficiency and Clean Mechanical Manufacture, School of Mechanical Engineering, Shandong University, Jinan 250061, China.
Zengyong
Z
Li
Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China; The Hong Kong Polytechnic University Shenzhen Research Institute, Hong Kong, China. Electronic address: ming.zhang@polyu.edu.hk.
Ming
M
Zhang
D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D020342:Finite Element Analysis; D033023:Foot Joints / Q000601:surgery*; D006801:Humans; D055595:Mechanical Phenomena; D011183:Postoperative Complications
Arthritis; Biomechanics; Contact pressure; Finite element analysis; Tarsometatarsal joints