title: Finite element model-based evaluation of tissue stress variations to fabricate corrective orthosis in feet with neutral subtalar joint.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  Finite element model.
  
  
  METHODS
  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.
  
  
  RESULTS
  The results demonstrate that the position of the calcaneum in the static stance position does contribute to the varying stress in the foot.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 1 SIHR & LC Hospital, Vellore, India.
authors.forename: Sathish
authors.initials: S
authors.lastname: Paul
authors.affiliation: 2 VIT University, Vellore, India.
authors.forename: Rekha
authors.initials: R
authors.lastname: Vijayakumar
authors.affiliation: 3 PSG Institute of Advanced Studies, Coimbatore, India.
authors.forename: Lazar
authors.initials: L
authors.lastname: Mathew
authors.affiliation: 4 Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
authors.forename: Sudesh
authors.initials: S
authors.lastname: Sivarasu
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D004867:Equipment Design; D005260:Female; D020342:Finite Element Analysis; D005528:Foot / Q000000981:diagnostic imaging; D061826:Foot Orthoses; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D066330:Printing, Three-Dimensional; D016059:Range of Motion, Articular / Q000502:physiology; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D013314:Stress, Mechanical; D013380:Subtalar Joint / Q000000981:diagnostic imaging* / Q000502:physiology*; D014057:Tomography, X-Ray Computed
keywords: Biomechanics of prosthetic/orthotic devices; Computer Aided Designing-Computer Aided Manufacturing (CAD-CAM); prosthetic design; prosthetics and orthotics in developing countries