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Biomechanical analysis of suture locations of the distal plantar fascia in partial foot

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Abstract

Purpose

The aim of this study was to evaluate the rationality of the suture locations of distal plantar fascia (DPF) after foot amputation to avoid the risk factors of re-amputation or plantar fasciitis.

Methods

The tensile strain of plantar fascia (PF) in the different regions was measured by uni-axial tensile experiment. A three-dimensional (3D) finite element model was also developed to simulate tensile behaviour of PF in weight bearing conditions. The model includes 12 bones, ligaments, PF, cartilage and soft tissues. Four suture location models for the DPF were considered: the fourth and fifth DPF were sutured on the third metatarsal, the cuboid, and both the third metatarsal and the cuboid, and one un-sutured model.

Results

The peak tensile strain of the first, second and third PF was 0.134, 0.128 and 0.138 based on the mechanical test, respectively. The fourth and fifth DPF sutured at the cuboid and the third metatarsal could offer more favourable outcomes. The peak strain of 4.859 × 10–2, 2.347 × 10–2 and 1.364 × 10–2 in the first, second and third PF showed the least outcomes in stance phase. Also, peak strain and stress of the residual PF reduced to 4.859 × 10–2 and 1.834 MPa, respectively. The stress region was redistributed on the mid-shaft of the first and third PF and the peak stress of medial cuneiform bone evidently decreased.

Conclusions

The fourth and fifth DPF suture at the third metatarsal and cuboid was appropriate for the partial foot. The findings are expected to suggest optimal surgical plan of the DPF suture and guide further therapeutic planning of partial foot patients.

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Acknowledgments

The project was supported by the National Natural Science Foundation of China (11120101001, 11202017, 11421202), National Science & Technology Pillar Program (2012BAI18B05, 2012BAI18B07), Research Fund for the Doctoral Program of Higher Education of China (20121102120039, 20131102130004) and 111 Project (B13003).

Conflict of interest

There are no conflicts of interest involved in the manuscript.

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Authors and Affiliations

  1. Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, 100191, Beijing, China

    Jun-Chao Guo, Li-zhen Wang, Zhong-Jun Mo, Wei Chen & Yu-Bo Fan

  2. National Research Centre for Rehabilitation Technical Aids, 100176, Beijing, China

    Zhong-Jun Mo & Yu-Bo Fan

  3. State Key Laboratory of Virtual Reality Technology and Systems, Beihang University, 100191, Beijing, China

    Jun-Chao Guo, Li-zhen Wang, Zhong-Jun Mo, Wei Chen & Yu-Bo Fan

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  1. Jun-Chao Guo
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  2. Li-zhen Wang
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  4. Wei Chen
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Correspondence to Li-zhen Wang or Yu-Bo Fan.

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Guo, JC., Wang, Lz., Mo, ZJ. et al. Biomechanical analysis of suture locations of the distal plantar fascia in partial foot. International Orthopaedics (SICOT) 39, 2373–2380 (2015). https://doi.org/10.1007/s00264-015-2889-1

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