Abstract
Second metatarsal stress fractures are a problematic injury for runners and are formed when the rate of repair of bone is outpaced by the damage accumulated during loading. Measuring the peak stresses on the bone during running gives an indication of damage accumulation but direct measurement is invasive. Finite element modelling is a viable alternative method of accurately estimating bone stresses but tends to be too computationally expensive for use in applied research. This study presents a novel and simple finite element model which can estimate bone stresses on the second metatarsal during the stance phase of walking and running, accounting for joint reaction forces and soft tissue effects. The influence of the forces and kinematic inputs to the model and the presence of the soft tissues was quantified using a sensitivity analysis. The magnitudes of maximum stress from the model are similar to existing finite element models and bone staple strain gauge values collected during walking and running. The model was found to be most sensitive to the pitch angle of the metatarsal and the joint reaction forces and was less sensitive to the ground reaction forces under the metatarsal head, suggesting that direct measurement of external forces should not be assumed to represent internal stresses.
Highlights
Stress fracture of the second metatarsal is a common overuse injury associated with running [1]
These modelling approaches range from beam theory models [9,10], which are computationally simple and lend themselves to analysis of larger groups of participants, to finite element models [11,12], which account for more realistic geometry and can include interactions with soft tissues
17,201 900 surface and soft tissues remained constant at numbers above 900 elements and the maximum stress on the cortical bone changed by only 0.01 MPa at element numbers above this
Summary
Stress fracture of the second metatarsal is a common overuse injury associated with running [1]. Mathematical modelling is a viable alternative to invasive research and has been used to quantify second metatarsal loading during both walking and running [7,9,10,11,12] These modelling approaches range from beam theory models [9,10], which are computationally simple and lend themselves to analysis of larger groups of participants, to finite element models [11,12], which account for more realistic geometry and can include interactions with soft tissues. Many models in the literature, such as that of Akrami [12], are extremely realistic, accounting for almost every tissue in the foot This high level of detail requires long computation times and sample sizes are small. Models of this nature are not suitable for applied research and understanding of population-wide overuse injuries such as metatarsal stress fractures.
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