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Related Experiment Video

Updated: Sep 29, 2025

Subject-specific Musculoskeletal Model for Studying Bone Strain During Dynamic Motion

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Published on: April 11, 2018

Orthosis and Foot Structure Affect the Fifth Metatarsal Principal Strains During Simulated Level Walking.

Jeffrey W Hoffman¹, Rogerio C Bitar², Nicholas Williams³

¹Hospital for Special Surgery, New York, New York, USA.

The American Journal of Sports Medicine

|March 18, 2022

Summary

Foot orthotics can reduce tensile strains on the proximal fifth metatarsal bone, potentially preventing fractures in athletes. Specific foot structures correlate with strain reduction, guiding orthotic selection for injury prevention.

Keywords:

bone morphology dynamic gait simulation fifth metatarsal fracture orthosis proximal fifth metatarsal

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Area of Science:

Biomechanics
Orthopedics
Sports Medicine

Background:

Proximal fifth metatarsal fractures are common in elite athletes, often leading to delayed healing.
Foot structural characteristics may predispose individuals to these fractures, necessitating preventive strategies.
While orthotics show promise, their precise effect on fifth metatarsal strains remains unclear.

Purpose of the Study:

To quantify how different foot orthotic designs affect principal tensile strains in the proximal fifth metatarsal bone during simulated walking.
To explore the relationship between foot anatomy and fifth metatarsal strains during walking.

Main Methods:

Utilized a robotic gait simulator with 10 cadaveric specimens to simulate level walking.
Measured strains at two key locations (zone II and zone III) on the proximal fifth metatarsal bone under 11 orthotic conditions.
Assessed foot structural features and correlated them with measured strains.

Main Results:

Two orthotic conditions significantly reduced strain in zone II, while six reduced strain in zone III compared to no orthotic use.
Increased strain in zone II correlated with higher Meary's angle.
Changes in zone III strain correlated with increased Meary's angle and fourth-fifth intermetatarsal angle.

Conclusions:

Orthotic devices can effectively reduce principal tensile strain in the proximal fifth metatarsal bone (zones II and III) during walking.
The effectiveness of strain reduction in zone III is linked to specific foot structural parameters like Meary's angle and the fourth-fifth intermetatarsal angle.
Clinicians can leverage foot structural assessments to prescribe optimal orthotics, potentially mitigating stress fracture risk in susceptible individuals.