NEU Faculty of Engineering

Department of Biomedical Engineering

Biomedical Solutions to Physical Foot Disabilities

Term Paper

By

Felix Chibuzo Obi

20144610

May 1, 2015

Introduction

Foot disability is the physical impairment, deformation of the foot in part or in whole. This

disability may be present from birth or occur during a person’s lifetime. Foot disability may

also include activity limitations and participation restrictions; these are the difficulties and

inability of a person to carryout simple tasks like standing, walking, running and the

problems experience by an Individual in carrying out these activities (Disabilities, 2015).

Biomedical Engineering is a fairly new discipline that incorporates the principle of Medicine,

Biology and Engineering to provide a range of solutions to Medical Problems. It focuses

mainly on the manufacturing, surgical Implantation and maintenance of artificial body parts

to augment, supplement or replace diseased or lost body parts.

Foot disabilities can involve one or more joints in the foot and/or their subordinate

surrounding Tissues. Some of these disabilities are acquired but some could be congenital.

This paper will discuss some common foot disabilities, some causes of foot disabilities, the

various types of foot disabilities and Biomedical solutions to these foot disabilities.

Causes of Foot Disabilities

Foot disabilities could be acquired during the course of one’s life or congenital, that is from

birth (Wow, 2015). Acquired feet disabilities are mostly due to accidents, diseases and some

inordinate life styles.

The cause of congenital foot disability is not fully understood both scientists believe that it

could be due to some genetic factors. Acquired foot disabilities could be caused by or

exacerbated by Injuries to the toes, wearing tight-fitting shoes, Bones and Muscle

imbalances, Arthritis and some genetic factors.

Foot Disabilities and their Biomedical Solutions

There are various types of foot disabilities, these include Bunions, Mallet Toes, Hammertoes

and Claw Toes, Diabetic foot Ulcer, Archillis tendonitis, Arthritis of the foot and Ankle, Flat

foot, Foot fractures and Heel Pain.

Biomedical Engineers typically correct foot fractures by surgical Orthopedic techniques

whiles they make use of Artificial Skin to treat foot Ulcer due these depends on the servirty

of the Ulcer.

Two of these disabilities and their biomedical solutions will be discussed in details.

Hallux Valgus (Bunion)

This disability is associated with the medial deviation of the first metatarsal and lateral

deviation of the big toe. The big toe is laterally deviated in relation to the first metatarsal

shaft and head. In some cases, in addition to the valgus deformity the toe is rotated inwardly,

that is away from the big toe of the opposite foot as shown in Figure 1 below.

Figure 1: A foot deformed by Hallux Valgus. (Source: http://en.wikipedia.org/wiki/BunionDownloaded on: 2015-05-11T07:19Z)

Bunions occur when pressure is applied to the side of the big toe forcing it inwards, towards,

and sometimes under or over, the other toes. As these pressure is applied, the tissues

surrounding the joint will become swollen and tender. It is believed that Bunions is primarily

caused by long term use of shoes especially tight fitting shoes with curved edges though it

could also be due to genetic factors. A survey was carried out on people from cultures that do

not wear shoes and no case of bunion was found, these gave credence to the hypothesis that

bunions are caused by ill-fitting shoes. Bunions can cause pains and discomfort to patients.

Wow, (2015) stated in his Journal that: Bunions can be corrected surgically to address one

or a combination of:

removing the abnormal bony enlargement of the first metatarsal.

realigning the first metatarsal bone relative to the adjacent metatarsal bone.

straightening the great toe relative to the first metatarsal and adjacent toes.

realigning the cartilagenous surfaces of the great toe joint.

addressing arthritic changes associated with the great toe joint.

repositioning the sesamoid bones beneath the first metatarsal bone.

shortening, lengthening, raising, or lowering the first metatarsal bone.

correcting any abnormal bowing or misalignment within the great toe.

Connecting two parallel long bones side by side by Syndesmosis Procedure.

The age, health, lifestyle and activity level of the patient may also play a role in the choice of

procedure. The leatest trend in the treatment of Bunions is the use of Laser surgery in which

narcotic analgesic is been used.

Mallet Toes, Hammertoes and Claw Toes

Millet toe is a feet disability that could be caused by Injuries to the toe, wearing shoes that

are too tight, Bones and Muscle imbalances, and Arthritis. Millet causes the joint at the end

of the toe to buckle and is typically associated with the second toe, these is due to the fact

that this toe is normally the longest in most people. Millet toe causes the skin near the toenail

tip to develop a painful corn and could result to an ulcer. The affected toe becomes reddish

and swollen, these could be extremely painful and poses difficulties in walking (Wow, 2015).

Glenn Copeland, (1992) defines Hammertoe as an unusual contraction of the toe, bent at the

middle portion of the toe. Bumps and corns also appear on top of the toe. Hammertoe

develop over time and eventually get to the point where it becomes obvious and painful.

Claw toe is a combination of hammertoe and mallet toe with the extra added deformity at the

base of the toe (the metatarsal phalangeal, MTP) joint, that is the joint at the base of the toe

close to the web space (Nicholas J. G, 1973). Claw toe can affect the second, third, fourth

and/or fifth toe and could cause severe pain and disconfort to the patient.

Biomidical Enginners correct these deformities and disabilities surgically by combining soft

tissues release or loosening the joint ligaments and transferring tendons to rebalance the

muscle pulling power in the toe. They can also shorten the toe by removing some bones at

the joint if neccessary. Hammer and Mallet toes are straightened and stiffened at the

proximal interphalangeal joint (PIP) or distal joints. Biomidical Enginners do these by

surgically place a pin in the toe, these allows the toe to stiffen in a straight position. The pin

is then removed three to six weeks after the surgery. Figure 2 below shows claw toes before

surgery and the corrected toe after surgery.

Figure 2: Claw toes and the corrected toes after surgery (Wow, 2015).

Conclusion

Biomedical engineering efforts are currently underway for virtually every type of foot

disability. It offer solutions which includes prosthesic Implantations, Surgical correction and

Medication. With Tissue Engineering, a new trend in Biomedical Engineering, the patients

skin can be produce from the patients own cell, these technique is very inportant in the

treatment of Diabetic foot Ulcer. Personnels who master the techniques of Tissue

Engineering will successful apply it to the treatment of foot and other forms of disabilities.

Prosthesis like the Artificial Skin are at different stages of development, with some already

being used clinically, a few in preclinical trials, and some

in the discovery stage. Recent progress suggests that these prosthesis will have an expanded

clinical application in the future because they represent a viable therapeutic option for those

who require tissue replacement. More recently, major advances in the areas of stem cell

biology, tissue engineering, and nuclear transfer techniques have made it possible to combine

these technologies to create the comprehensive scientific field of regenerative medicine,

these technique will be of utmost important in the treatment of Diabetic foot Ulcer.

References

Department of Health and Social Security, “More trouble with feet: A survey of the foot

problem and chiropody needs of the elderly,” (London: Stationery Office Book, 1986)

Glenn Copeland, D. P. M, The Foot Book, Relief for Overused, Abused and Ailing Feet

(Toronto: Wiley, 1997)

Kozak, Campbell, Frykberg, and Habershaw, “Management of Diabetic Foot Problems”,

Annals of Surgery, Second Edition, (USA: Lippincott, Williams, and Wilkins, 1996) pp 103

and 104

M. David Tremaine, MD. Elias M. Awad, The Foot & Ankle, (New England: Lowell

House, 1995)

Nicholas J. Giannestras, “Foot Disorder: Medical and Surgical Management,” (UK:

Wiley’s Surgery Collection, 1973) pp 521

SHULMAN, Pod.D and SAMUEL B, "Survey in China and India of Feet That Have

Never Worn Shoes,"The Journal of the National Association of Chiropodists, (China:

1973, Retrieved27 September 2012)

Wikipedia, “Disabilities,” http://en.wikipedia.org/wiki/Disability, (The Free

Encyclopedia: 2015)

Wow, “A Journals on Bunions,” http://us.wow.com/wiki/Bunion?

s_chn=18&s_pt=source2&v_t=aolsem, (Wikipedia, Site Visited on 2015/05/11 T07:19Z)

Wynn D.P.M. and Michael H, "Soft-Tissue Bunion Repair with a CO2 Surgical

Laser," The Journal of Current Podiatric Medicine (1986) pp 27–28.