Finite element method based parametric study of Gastrocnemius-soleus recession: implications to the treatment of midfoot-forefoot overload syndrome

Miko Lin Lv, Haowei Zhang, Liang Chen, Ying Liu, Fei Wang, Duo Wai Chi Wong, Li Sun, Ming Ni

Research output: Journal article publicationJournal articleAcademic researchpeer-review

1 Citation (Scopus)

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.

Original languageEnglish
Pages (from-to)913-921
Number of pages9
JournalComputer Methods in Biomechanics and Biomedical Engineering
Volume24
Issue number8
DOIs
Publication statusPublished - 11 Jun 2021

Keywords

  • ankle equinus
  • Baumann procedure
  • Gastrocnemius contracture
  • plantar fasciitis
  • Strayer procedure
  • Vulpius procedure

ASJC Scopus subject areas

  • Bioengineering
  • Biomedical Engineering
  • Human-Computer Interaction
  • Computer Science Applications

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