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Title: Finite element analysis of generalized ligament laxity on the deterioration of hallux valgus deformity (Bunion)
Authors: Wong, DWC 
Wang, Y 
Chen, TLW 
Yan, F 
Peng, Y 
Tan, Q 
Ni, M
Leung, AKL 
Zhang, M 
Issue Date: 8-Sep-2020
Source: Frontiers in bioengineering and biotechnology, 8 Sept. 2020, v. 8, 571192, p. 1-14
Abstract: Hallux valgus is a common foot problem affecting nearly one in every four adults. Generalized ligament laxity was proposed as the intrinsic cause or risk factor toward the development of the deformity which was difficult to be investigated by cohort clinical trials. Herein, we aimed to evaluate the isolated influence of generalized ligament laxity on the deterioration using computer simulation (finite element analysis). We reconstructed a computational foot model from a mild hallux valgus participant and conducted a gait analysis to drive the simulation of walking. Through parametric analysis, the stiffness of the ligaments was impoverished at different degrees to resemble different levels of generalized ligament laxity. Our simulation study reported that generalized ligament laxity deteriorated hallux valgus by impairing the load-bearing capacity of the first metatarsal, inducing higher deforming force, moment and malalignment at the first metatarsophalangeal joint. Besides, the deforming moment formed a deteriorating vicious cycle between hallux valgus and forefoot abduction and may result in secondary foot problems, such as flatfoot. However, the metatarsocuneiform joint did not show a worsening trend possibly due to the overriding forefoot abduction. Controlling the deforming load shall be prioritized over the correction of angles to mitigate deterioration or recurrence after surgery.
Keywords: Finite element method
Forefoot abduction
Hallux abducto valgus
Metatarsus primus varus
Publisher: Frontiers Media SA
Journal: Frontiers in bioengineering and biotechnology 
EISSN: 2296-4185
DOI: 10.3389/fbioe.2020.571192
Rights: Copyright © 2020 Wong, Wang, Chen, Yan, Peng, Tan, Ni, Leung and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) ( The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
The following publication Wong, D. W. C., Wang, Y., Chen, T. L. W., Yan, F., Peng, Y. H., Tan, Q. T., . . . Zhang, M. (2020). Finite Element Analysis of Generalized Ligament Laxity on the Deterioration of Hallux Valgus Deformity (Bunion). Frontiers in Bioengineering and Biotechnology, 8, 14 is available at
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