Please use this identifier to cite or link to this item: http://hdl.handle.net/10397/24245
Title: Effects of plantar fascia stiffness on the biomechanical responses of the ankle-foot complex
Authors: Cheung, JTM
Zhang, M 
An, KN
Keywords: Fasciotomy
Finite element model
Ligaments
Strain
Stress
Issue Date: 2004
Publisher: Elsevier Sci Ltd
Source: Clinical biomechanics, 2004, v. 19, no. 8, p. 839-846 How to cite?
Journal: Clinical Biomechanics 
Abstract: Background. The plantar fascia is one of the major stabilizing structures of the longitudinal arch of human foot, especially during midstance of the gait cycle. Knowledge of its functional biomechanics is important for establishing the biomechanical rationale behind different rehabilitation, orthotic and surgical treatment of plantar fasciitis. This study aims at quantifying the biomechanical responses of the ankle-foot complex with different plantar fascia stiffness. Methods. A geometrical detailed three-dimensional finite element model of the human foot and ankle, incorporating geometric and contact nonlinearities was constructed by 3D reconstruction of MR images. A sensitivity study was conducted to evaluate the effects of varying elastic modulus (0-700 MPa) of the plantar fascia on the stress/strain distribution of the bony, ligamentous and encapsulated soft tissue structures. Findings. The results showed that decreasing the Young's modulus of plantar fascia would increase the strains of the long and short plantar and spring ligaments significantly. With zero fascia Young's modulus to simulate the plantar fascia release, there was a shift in peak von Mises stresses from the third to the second metatarsal bones and increased stresses at the plantar ligament attachment area of the cuboid bone. Decrease in arch height and midfoot pronation were predicted but did not lead to the total collapse of foot arch. Interpretation. Surgical dissection of the plantar fascia may induce excessive strains or stresses in the ligamentous and bony structures. Surgical release of plantar fascia should be well-planned to minimise the effect on its structural integrity to reduce the risk of developing arch instability and subsequent painful foot syndrome.
URI: http://hdl.handle.net/10397/24245
ISSN: 0268-0033
DOI: 10.1016/j.clinbiomech.2004.06.002
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