Investigation of plantar barefoot pressure and soft-tissue internal stress: A three-dimensional finite element analysis

Abstract

Mechanical loading acting on the foot plantar soft-tissue in the form of focal stress plays a central pathogenic role in the onset of diabetic neuropathic ulcers. Current instruments which merely allow superficial estimate of plantar loading acting on the foot, severely limit the scope of many biomechanical/clinical studies on this issue. Recent studies have suggested that peak plantar pressure may be only 65% specific for the development of ulceration. These limitations are at least partially due to surface pressures not being representative of the complex mechanical stress developed inside the subcutaneous plantar soft-tissue, which are potentially more relevant for tissue breakdown. This ..