Evaluation of the Load Path Through the Foot/Ankle Complex in Various Postures Through Cadaveric and Finite Element Model Testing

Abstract

The foot/ankle complex (particularly the hindfoot) is frequently injured in a wide array of debilitating events, such as car crashes. Numerical models have been used to assess injury risk, but most are minimally validated and do not account for variations in ankle posture that frequently occur during these events. The purpose of this study was to develop an accurate finite element (FE) model of the foot and ankle that accounts for these positional changes. The bone positions and load path in the foot and ankle were quantified throughout its natural range of motion. CT scans were taken of a male cadaveric leg in five postures in which fractures are commonly reported, while strains were recorded by strain gauges attached to the hindfoot bones in response to quasi-static, sub-failure loading. Substantial variations in bone displacements, rotations and strains were observed for all postures tested, highlighting the need for an FE model that accounts for these positional changes. The CT scans were used as the basis of an FE model of the foot and ankle that was developed using TrueGrid® and LS-Dyna® software. The model met rigorous mesh quality criteria, and its properties were optimized to best represent the experimental plantar tissue compression and surface strains. The model was evaluated by comparing its bone position and strain responses to the experimental results in each posture. The fracture thresholds and locations in each posture were estimated and were similar to those reported in the literature. The least vulnerable posture was neutral, and the talus and calcaneus exhibited the lowest fracture thresholds in all postures. This work will be useful in developing improved injury limits for the ankle and postural guidelines to minimize injury. The model can be used to evaluate new protective systems to reduce the occurrence of lower leg injuries.