The influence of foot posture, support stiffness, heel pad loading and tissue mechanical properties on biomechanical factors associated with a risk of heel ulceration

Ran Sopher, Jane Nixon, Elizabeth McGinnis, Amit Gefen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

60 Scopus citations

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.

Original languageEnglish
Pages (from-to)572-582
Number of pages11
JournalJournal of the Mechanical Behavior of Biomedical Materials
Volume4
Issue number4
DOIs
StatePublished - May 2011

Funding

FundersFunder number
Leeds Fund for International Research Collaboration
University of Leeds
Fondazione Italiana per la Ricerca sul Cancro

    Keywords

    • Deep tissue injury
    • Fat pad
    • Finite element
    • Finite element model
    • Heel ulcers
    • Pressure ulcer
    • Strain energy density
    • Three-dimensional
    • Tissue damage

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