Finite Element Simulation of Clubfoot Correction: A Feasibility Study Toward Patient-Specific Casting.

Area of Science:

• Biomechanics
• Medical Imaging
• Computational Modeling

Background:

• Congenital talipes equinovarus (clubfoot) is a common birth defect affecting 1-2 per 1000 newborns globally.
• The Ponseti method is the standard treatment, but its underlying biomechanical processes are not fully understood due to limited imaging.
• Computational modeling offers a non-invasive method to study clubfoot correction and explore applications like custom casts.

Purpose of the Study:

• To develop and validate a computational framework using iterative finite element analysis (iFEA) for simulating Ponseti method corrections.
• To assess the impact of model simplification (homogeneous vs. non-homogeneous) on the accuracy of clubfoot correction simulations.
• To lay the groundwork for advanced applications such as patient-specific modeling and customized cast design.

Main Methods:

• A 3D surface model of a clubfoot was created and subjected to stepwise deformations using iFEA.
• Correction was quantified using standard angular measurements (Cavus, Adductus, Varus, Equinus, Derotation).
• A homogeneous soft tissue model and a non-homogeneous model with bone structure were compared using an adult leg model.

Main Results:

• The iFEA framework successfully reproduced progressive geometric changes consistent with Ponseti correction in the training model (mean angular deviation ±3.2°).
• Homogeneous and non-homogeneous adult leg models yielded comparable correction geometries (<2° difference), with the homogeneous model being computationally efficient.
• The study utilized computational loads, not direct physiological forces, to drive the simulated corrections.

Conclusions:

• Iterative finite element analysis (iFEA) can effectively simulate surface-level geometric changes associated with Ponseti clubfoot correction, irrespective of model homogeneity.
• This computational framework provides a feasible basis for future research incorporating clinical forces, pediatric tissue properties, and patient-specific geometries.
• Potential applications include the development of customized 3D-printed casts for clubfoot treatment.