Finite element method based parametric study of Gastrocnemius-soleus recession: implications to the treatment of midfoot-forefoot overload syndrome. Issue 8 (11th June 2021)

• Record Type: Journal Article
• Authors: Lv, Miko Lin; Zhang, Haowei; Chen, Liang; Liu, Ying; Wang, Fei; Wong, Duo Wai-Chi; Sun, Li; Ni, Ming
• Is Part Of: Computer methods in biomechanics and biomedical engineering. Volume 24:Issue 8(2021)
• Page Start: 913
• Page End: 921
• Publication Date: 2021-06-11
• Subjects: Gastrocnemius contracture -- ankle equinus -- Strayer procedure -- Vulpius procedure -- Baumann procedure -- plantar fasciitis; Biomechanics -- Data processing -- Periodicals; Biomedical engineering -- Periodicals; Biomechanics -- Periodicals; Biomedical Engineering -- methods -- Periodicals; Computing Methodologies -- Periodicals; 612.7
• DOI: 10.1080/10255842.2020.1858817
• Languages: English
• ISSNs: 1025-5842

Abstract

Abstract: Gastrocnemius-soleus recession has been used to treat midfoot-forefoot overload syndrome and plantar fasciitis induced by equinus of the ankle joint. A controlled and selective amount of recession is imperative to maintain muscle strength and stability. The objective of this study was to conduct a parametric study to quantify the relationship between the level of recession and plantar fascia stress. A finite element model of the foot-ankle-shank complex was reconstructed from magnetic resonance and computed tomography images of a 63-year-old normal female. The model was validated by comparing modeled stresses to the measured plantar pressure distribution of the model participant during balanced standing. The midstance and push-off instants of walking stance were simulated with different levels and combinations of gastrocnemius-soleus recession resembled by different amounts of muscle forces. Halving the muscle forces at midstance reduced the average plantar fascia stress by a quarter while reducing two-third of the muscle forces at push-off reduced the average fascia stress by 18.2%. While the first ray of the plantar fascia experienced the largest stress among the five fasciae, the stress was reduced by 77.8% and 16.9% when the load was halved and reduced by two-third at midstance and push-off instants, respectively. Reduction in fascia stress implicates a lower risk of plantar fasciitis and other midfoot-forefoot overload syndromes. The outcome of this study can aid physicians to determine the amount of gastrocnemius-soleus recession towards patients with vdifferent levels of plantar fascia overstress. A detailed three-dimensional modelling on the plantar fascia is warranted in future study.