Talip ÇELİK, Yasin KİŞİOĞLU, Zeliha COŞKUN

Topuklu ve Topuksuz Ayakkabı İçin Birinci Metatarsal Kemik Üzerindeki Stress Dağılımının Karşılaştırılması

Bu çalışmanın amacı topuklu ve topuksuz ayakkabı giyildiğinde birinci metatarsal kemik üzerinde oluşan stress dağılımı ve total deformasyondaki değişimi sonlu elemanlar metoduyla incelemektir. Birinci metatarsal kemik, bilgisayarlı tomografi (BT) görüntüsünden üç boyutlu olarak modellenmiş ve ANSYS Workbench yazılımına aktarılmıştır. Proximal bölgeden sınır şartlarına göre sabitlenen kemiğe vücut ağırlığı, kas kuvvetleri uygulanmıştır. Analiz sonucu stress, toplam deformasyon ve gerinim değerleri olmak üzere üç farklı kritere bakılarak değerlendirilmiştir. Değişen stress ve gerinim değerlerinin kemik hasarına neden olup olmadığı incelenmiş ayrıca stabilite açısından kemiğin deformasyonu değerlendirilmiştir. Sonuç olarak, yüksek topuklu ayakkabının , düz ayakkabılara nazaran birinci metatarsal kemik üzerindeki stress değerini % 54 arttırdığı sonucuna varılmıştır. Gerilme değerlerinin kemik çatlağı veya kırığına neden olmadığı sonucuna varılırken, yüksek topuklu ayakkabı giymenin birinci metatarsal kemik üzerinde oluşan deformasyonu artırdığı gözlemlenmiştir. Çalışmanın sonucu yüksek topuklu ayakkabı giymenin birinci metatarsal kemiği olumsuz etkilediği yönündedir. Bu nedenle günlük hayatta yüksek topuklu ayakkabı kullanım sıklığı azaltılmalı ve yüksek topuklu ayakkabı dizaynı kemikte oluşan gerilmeler dikkate alınarak yapılmalıdır.

Comparision of the Stress Distribution Between High-Heeled and Flat Shoes on The First Metatarsal Bone

The aim of this study is to examine the effects of the wearing high-heeled shoes (HHS) by comparing the wearing the flat shoes onthe first metatarsal bone using the finite element method. The first metatarsal bone is modeled from computerized tomography(CT) image as 3D and imported to ANSYS Workbench Software. Body weight (BW) and muscle forces were applied to the firstmetatarsal bone. The bone was fixed at the proximal region of the bone for the boundary conditions. Three evaluation criteria wereexamined for the results as the stresses, the total deformations and the strain values on the bone. The stress and strain distributionsof the bone were evaluated for the bone failure. The deformation of the bone were evaluated for the bone stabilitiy. As a result, thewearing HHS increases the stress values on the first metatarsal bone approximately %54 compared to the flat shoes. The strainvalues showed that the bone crack or failure was not occured. The deformation of the bone was increased when wearing the HHSshoes. The conclusion of the study is that the wearing HHS negatively affects the first metatarsal bone. Hence, the frequency ofthe wearing HHS in daily life should be reduced and heeled shoe designs should be made taking into account the stresses occuredon the bone.

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[1] Cronin, N. J., “The effects of high heeled shoes on female gait: a review” Journal of Electromyography and Kinesiology, 24(2): 258-263, (2014).
[2] Wiedemeijer, M. M., and Otten, E. “Effects of high heeled shoes on gait. A review” Gait & posture, 61, 423- 430, (2018).
[3] Esenyel, M., Walsh, K., Walden, J. G., & Gitter, A., “Kinetics of high-heeled gait” Journal of the American Podiatric Medical Association, 93(1): 27- 32, (2003).
[4] Spencer, S., “Biomechanical effects of shoe gear on the lower extremity” Clinics in podiatric medicine and surgery, 37(1): 91-99, (2020).
[5] Hapsari, V. D., Xiong, S., & Yang, S. September). “High heels on human stability and plantar pressure distribution: Effects of heel height and shoe wearing experience” In Proceedings of the Human Factors and Ergonomics Society Annual Meeting 58(1): 1653-1657, (2014).
[6] Ng, E. Y. L. “Foot problems and their implications for footwear design” Woodhead Publishing In Handbook of Footwear Design and Manufacture, 90-114, (2013).
[7] Afzal, F., & Manzoor, S. “Prolong wearing of high heeled shoes can cause low back pain” J Nov Physiother, 7(356): 2, (2017).
[8] Lee, C. M., Jeong, E. H., & Freivalds, A. “Biomechanical effects of wearing high-heeled shoes” International journal of industrial ergonomics, 28(6): 321-326, , (2001).
[9] Lee, S., & Li, J. X., “Effects of high-heeled shoes and asymmetrical load carrying on lower-extremity kinematics during walking in young women” Journal of the American Podiatric Medical Association, 104(1): 58-65, (2014).
[10] Speksnijder, C. M., vd Munckhof, R. J., Moonen, S. A., & Walenkamp, G. H. “The higher the heel the higher the forefoot-pressure in ten healthy women” The foot, 15(1): 17-21, (2005).
[11] Sayeed, M. A., Rony, S. M. A., Arefin, M. S., & Uddin, M. B. “Investigation of Bodyweight Distribution on Metatarsophalangeal Joint of Human Foot for Ladies High Heel Footwear”
[12] Cong, Y., Cheung, J. T. M., Leung, A. K., & Zhang, M. “Effect of heel height on in-shoe localized triaxial stresses” Journal of biomechanics, 44(12), 2267-2272, (2011).
[13] Gu, Y., Lu, Y., & Li, J. “Finite Element Analyze Of The First Metatarsal Vertical Arch Of The Foot In The HighHeeled Gait” In ISBS-Conference Proceedings Archive. (2005).
[14] Jacob, H. A. C. “Forces acting in the forefoot during normal gait–an estimate” Clinical Biomechanics, 16(9): 783-792, (2001).
[15] Matzaroglou, C., Bougas, P., Panagiotopoulos, E., Saridis, A., Karanikolas, M., & Kouzoudis, D. “Ninetydegree chevron osteotomy for correction of hallux valgus deformity: clinical data and finite element analysis” The open orthopaedics journal, 4, 152, (2010).
[16] Yu, J., Cheung, J. T. M., Wong, D. W. C., Cong, Y., & Zhang, M., “Biomechanical simulation of high-heeled shoe donning and walking” Journal of biomechanics, 46(12): 2067-2074, (2013).
[17] Moerenhout, K., Chopra, S., & Crevoisier, X., “Outcome of the modified Lapidus procedure for hallux valgus deformity during the first year following surgery: A prospective clinical and gait analysis study” Clinical Biomechanics, 61, 205-210 (2019).
[18] Hayafune, N., Hayafune, Y., & Jacob, H. A. C., “Pressure and force distribution characteristics under the normal foot during the push-off phase in gait” The foot, 9(2): 88-92, (1999).
[19] Stefanyshyn, D. J., Nigg, B. M., Fisher, V., O'Flynn, B., & Liu, W., ”The influence of high heeled shoes on kinematics, kinetics, and muscle EMG of normal female gait” Journal of Applied Biomechanics, 16(3): 309-319, (2000).
[20] Yung-Hui, L., & Wei-Hsien, H., “Effects of shoe inserts and heel height on foot pressure, impact force, and perceived comfort during walking” Applied ergonomics, 36(3): 355 – 362, (2005).
[21] Hong, W. H., Lee, Y. H., Chen, H. C., Pei, Y. C., & Wu, C. Y. “Influence of heel height and shoe insert on comfort perception and biomechanical performance of young female adults during walking” Foot & ankle international, 26(12): 1042-1048, (2005).
[22] Yu, J., Cheung, J. T. M., Fan, Y., Zhang, Y., Leung, A. K. L., & Zhang, M., “Development of a finite element model of female foot for high-heeled shoe design” Clinical Biomechanics, 23, 31-38, (2008).
[23] Stokes, I. A., Hutton, W. C., & Stott, J. R. “Forces acting on the metatarsals during normal walking” Journal of anatomy, 129(Pt 3): 579, (1979).
[24] Sussman, R. E., & D'Amico, J. C. “The influence of the height of the heel on the first metatarsophalangeal joint” Journal of the American Podiatry Association, 74(10): 504, (1984).
[25] McBride, I. D., Wyss, U. P., Cooke, T. D. V., Murphy, L., Phillips, J., & Olney, S. J. “First metatarsophalangeal joint reaction forces during high-heel gait.” Foot & ankle, 11(5): 282-288, (1991).
[26] Yassine, R. A., Elham, M. K., Mustapha, S., & Hamade, R. F. “A detailed methodology for FEM analysis of long bones from CT using Mimics” In ASME 2017 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers Digital Collection, (2017, November).
[27] Rho, J. Y., Hobatho, M. C., & Ashman, R. B. “Relations of mechanical properties to density and CT numbers in human bone” Medical engineering & physics, 17(5): 347-355, (1995).
[28] Hart, N. H., Nimphius, S., Rantalainen, T., Ireland, A., Siafarikas, A., & Newton, R. U..”Mechanical basis of bone strength: influence of bone material, bone structure and muscle action.” Journal of musculoskeletal & neuronal interactions, 17(3): 114, (2017)