Analysis of stresses in two-dimensional models of normal and neuropathic feet.

A two-dimensional model of the normal foot skeleton, which includes cartilages and ligaments, is used in this analysis of stresses during three quasi-static walking phases: heel-strike, mid-stance and push-off. It is found that in all the walking phases the maximum values of principal stresses occur in the dorsal anterior region of the talus, whereas the highest stress occurs in the push-off phase. The model is used for the simulation of muscle paralysis and its effect on the distribution of principal stresses. Subsequently, the model is used to analyse stresses in the deformed feet of three leprosy patients with complete paralysis of certain muscles. The results demonstrate that both the shape of the foot and the type of muscle paralysis contribute to the development of high stresses in different regions of the foot. These high stresses in regions with reduced mechanical strength could be one of the important factors in the process of tarsal disintegration in leprosy.