@article{b2e4eaacc89b4d73aa202bcfefef9325,
title = "The influence of foot posture, support stiffness, heel pad loading and tissue mechanical properties on biomechanical factors associated with a risk of heel ulceration",
abstract = "Heel ulcers (HU) are the second most common type of pressure ulcers. In this work, we developed the first anatomically-realisstic three-dimensional finite elemenedt model of the posterior heel for studying the risk for HU in bedridden patients. We specifically simulated a heel that is resting on supports with different stiffnesses at upright and inclined foot postures. Our objective was to examine the effects of foot posture and stiffness of the support on strains and stresses within the fat pad of the resting heel. We found that strains and stresses in the fat pad of the heel are considerably reduced when the foot is positioned so that its lateral aspect is at 90° with respect to the horizon compared to an abducted (60°) foot posture. The study therefore indicates that theoretically, an inclined foot posture puts a bedridden patient at a higher risk for HU with respect to an upright foot posture, which may be explained by the anatomy of the heel that faces a lower curvature and better cushioned region against the support when the foot is upright.",
keywords = "Deep tissue injury, Fat pad, Finite element, Finite element model, Heel ulcers, Pressure ulcer, Strain energy density, Three-dimensional, Tissue damage",
author = "Ran Sopher and Jane Nixon and Elizabeth McGinnis and Amit Gefen",
note = "Funding Information: The authors are thankful to Ms. Michal Stern-Perry, M.Sc. student in the Musculoskeletal Biomechanics Laboratory (AG) at the Department of Biomedical Engineering of the Faculty of Engineering at Tel Aviv University, Israel, for her kind help in developing the FE models. This work was partially supported by a networking grant from the Leeds Fund for International Research Collaboration (FIRC) (Sponsors: Worldwide Universities Network and the University of Leeds) (JN, AG) .",
year = "2011",
month = may,
doi = "10.1016/j.jmbbm.2011.01.004",
language = "אנגלית",
volume = "4",
pages = "572--582",
journal = "Journal of the Mechanical Behavior of Biomedical Materials",
issn = "1751-6161",
publisher = "Elsevier Ltd.",
number = "4",
}