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Impact Biomechanics of the Foot

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The Biomechanics of Impact Injury

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Abstract

This chapter deals with the biomechanics of impact injuries of the foot. In current vehicles, foot injuries are usually the result of footwell intrusion caused by an offset frontal impact. The force applied to the plantar (bottom) surface of the foot can result in injury to both the midfoot and the hindfoot. In the early days of aviation, the brake pedal in open cockpit single seaters was a round bar and there are anecdotal records of pilots breaking their feet (midfoot) while doing a crash landing. In the nineteenth century, French surgeon, Jacques Lisfranc de St. Martin (1790–1847) treated injuries to the midfoot of Napoleon’s cavalrymen when their foot got caught in the stirrups after they fell from their horse. This serious foot injury is now named after Lisfranc.

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Author information

Authors and Affiliations

  1. Department of Biomedical Engineering, Wayne State University, Detroit, MI, USA

    Albert I. King

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  1. Albert I. King
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Appendices

Questions for Chapter 15

  1. 15.1.

    Cadaveric foot fractures have been reproduced in the laboratory

    1. [ ] (i)

      These fractures were due solely to the application of large forces on the brake pedal by the driver

    2. [ ] (ii)

      These fractures were due to the footwell intrusion in conjunction with brake pedal force

    3. [ ] (iii)

      These fractures were due to brake pedal force and forces in the tendons of the foot

    4. [ ] (iv)

      These fractures have an unknown injury mechanism

    5. [ ] (v)

      None of the above

  2. 15.2.

    A Lisfranc foot injury has to do with

    1. [ ] (i)

      Fracture of the calcaneus

    2. [ ] (ii)

      Fracture of tarsal bone

    3. [ ] (iii)

      Rupture of the Achilles tendon

    4. [ ] (iv)

      Fracture of the navicular bone

    5. [ ] (v)

      None of the above

  3. 15.3.

    The mechanism for a Lisfranc foot injury is

    1. [ ] (i)

      Tension applied to the metatarsal bones

    2. [ ] (ii)

      Shearing at the phalangeal-metatarsal joint

    3. [ ] (iii)

      Axial loading of the metatarsal head by the plantar flexed phalange

    4. [ ] (iv)

      Bending of the metatarsal bones

    5. [ ] (v)

      None of the above

  4. 15.4.

    Lisfranc injuries are more likely to occur in drivers who are short in stature because

    1. [ ] (i)

      They sit up straight in order to see the road

    2. [ ] (ii)

      They plantar flex their toes to reach the brake pedal

    3. [ ] (iii)

      They sit too close to the steering wheel

    4. [ ] (iv)

      Their knees are up against the dash

    5. [ ] (v)

      They cannot see the hood ornament

  5. 15.5.

    In the experiments performed by Smith et al. (2005), he was able to reproduce Lisfranc injuries in the laboratory

    1. [ ] (i)

      by impacting the foot in the plantar normal configuration at impact speeds less than 16 m/s

    2. [ ] (ii)

      by impacting the foot in the plantar normal configuration at impact speeds ranging from 2.8 to 15.5 m/s

    3. [ ] (iii)

      by impacting the foot in the plantar flexed configuration at impact speeds at or over 16 m/s

    4. [ ] (iv)

      by impacting the foot in the plantar flexed configuration at impact speeds as low as 2.8 m/s

    5. [ ] (v)

      None of the above

  6. 15.6.

    Lisfranc injuries can include

    1. [ ] (i)

      Fracture of the phalanges of the first and second toe

    2. [ ] (ii)

      Rupture or avulsion of the Lisfranc ligament

    3. [ ] (iii)

      Dislocation or fracture/dislocation of the tarsal/metatarsal joints

    4. [ ] (iv)

      Rupture of the deltoid ligament

    5. [ ] (v)

      (ii) and (iii)

  7. 15.7.

    The tolerance of the foot to dorsiflexion is

    1. [ ] (i)

      yet to be determined

    2. [ ] (ii)

      is 45 degrees

    3. [ ] (iii)

      ranges from 50 to 70 degrees

    4. [ ] (iv)

      is less than 30 degrees

    5. [ ] (v)

      None of the above

  8. 15.8.

    Foot ligaments can be injured by ankle inversion and eversion

    1. [ ] (i)

      The lateral ligaments are injured due to inversion

    2. [ ] (ii)

      The medial ligaments are injured due to eversion

    3. [ ] (iii)

      The lateral ligaments are injured due to eversion

    4. [ ] (iv)

      The medial ligaments are injured due to inversion

    5. [ ] (v)

      (i) and (ii)

  9. 15.9.

    External rotation of the foot while it is in dorsiflexion can cause ankle injuries. These include

    1. [ ] (i)

      Medial malleolar fractures

    2. [ ] (ii)

      Lateral malleolar fractures

    3. [ ] (iii)

      Avulsion of the anterior talofibular ligament

    4. [ ] (iv)

      All of the above

    5. [ ] (v)

      None of the above

  10. 15.10.

    Automotive drivers can sustain foot injuries during an offset frontal crash. The cause of these injuries is

    1. [ ] (i)

      due to heavy braking

    2. [ ] (ii)

      due to bending of the foot over the brake pedal

    3. [ ] (iii)

      due to the type of shoe worn

    4. [ ] (iv)

      due to the heel losing contact with the floor of the footwell

    5. [ ] (v)

      due to intrusion of the footwell

Answers to Problems by Chapter

Prob

Ans

1

(ii)

2

(v)

3

(iii)

4

(ii)

5

(v)

6

(v)

7

(ii)

8

(v)

9

(ii)

10

(v)

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King, A.I. (2018). Impact Biomechanics of the Foot. In: The Biomechanics of Impact Injury. Springer, Cham. https://doi.org/10.1007/978-3-319-49792-1_15

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  • DOI: https://doi.org/10.1007/978-3-319-49792-1_15

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  • Online ISBN: 978-3-319-49792-1

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