Linked Life Data

12787987

Source:http://linkedlifedata.com/resource/pubmed/id/12787987

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
6
pubmed:dateCreated
2003-6-5
pubmed:abstractText
Diabetes mellitus (type 2) is the most frequent cause of non-traumatic lower-limb amputations. The major cause of impairment to the feet of diabetics is persistent hyperglycemia, potentially leading to peripheral neuropathy as well as to pathological changes in plantar soft tissue, which stiffen its structure and diminish its ability to effectively distribute foot-ground contact loads. In this study, a computational model of the foot structure in the standing position was utilized to evaluate stress distributions in plantar soft tissue under the medial metatarsal heads of simulated diabetic versus normal feet. The model comprises five anatomic planar cross-sections in the directions of the foot rays, which were solved for internal stresses under static ankle joint reaction (300 N) and triceps surae muscle forces (150 N) using the finite element method. Tissues were assumed to be homogenous, isotropic and elastic materials, with nonlinear stress-strain relations for the ligaments, fascia and plantar tissue. The model revealed significant tension stress concentrations (90-150 KPa) in the plantar pad of the simulated diabetic forefoot: they were four times the normal maximum stress under the first metatarsal head and almost eight times the normal maximum stress under the second metatarsal head. It was shown that with increased severity of stiffening of the plantar pad, as related to glucose-exposure, peak forefoot contact stresses may rise by 38 and 50% under the first and second metatarsal heads, respectively. The increase in averaged (von Mises) internal stresses within the plantar soft tissue is even more pronounced, and may rise by 82 and 307% for the tissue under the first and second metatarsal heads, respectively. These results, which conform to experimental data gathered over the last two decades, suggest that the process of injury in diabetic feet is very likely to initiate not on the skin surface, but in deeper tissue layers, and the tissues underlying the distal bony prominences of the medial metatarsals are the most vulnerable ones.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Jul
pubmed:issn
1350-4533
pubmed:author
pubmed:issnType
Print
pubmed:volume
25
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
491-9
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed:year
2003
pubmed:articleTitle
Plantar soft tissue loading under the medial metatarsals in the standing diabetic foot.
pubmed:affiliation
Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv 69978, Israel. gefen@eng.tau.ac.il
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't, Evaluation Studies, Validation Studies