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<art>
   <ui>1757-1146-1-S1-K2</ui>
   <ji>1757-1146</ji>
   <fm>
      <dochead>Keynote presentation</dochead>
      <bibl>
         <title>
            <p>Sailing charted seas: biomechanics and the orthopedic surgeon</p>
         </title>
         <aug>
            <au id="A1" ca="yes">
               <snm>Arangio</snm>
               <mi>A</mi>
               <fnm>George</fnm>
               <insr iid="I1"/>
               <email>casarangio@aol.com</email>
            </au>
         </aug>
         <insg>
            <ins id="I1">
               <p>Department Orthopaedic Surgery, Penn State, Milton S. Hershey Medical College</p>
            </ins>
         </insg>
         <source>Journal of Foot and Ankle Research</source>
         <supplement>
            <title>
               <p>1st Congress of the International Foot &amp; Ankle Biomechanics (i-FAB) community</p>
            </title>
            <editor>Alberto Leardini, Chris Nester, Alex Stacoff and Dieter Rosenbaum</editor>
            <note>Meeting abstracts &#8211; A single PDF containing all abstracts in this Supplement is available <a href="http://www.biomedcentral.com/content/files/pdf/1757-1146-1-S1-full.pdf">here</a>.</note>
            <url>http://www.biomedcentral.com/content/pdf/1757-1146-1-S1-info.pdf</url>
         </supplement>
         <conference>
            <title>
               <p>1st Congress of the International Foot &amp; Ankle Biomechanics (i-FAB) community</p>
            </title>
            <location>Bologna, Italy</location>
            <date-range>4&#8211;6 September 2008</date-range>
            <url>http://www.i-fab.org</url>
         </conference>
         <issn>1757-1146</issn>
         <pubdate>2008</pubdate>
         <volume>1</volume>
         <issue>Suppl 1</issue>
         <fpage>K2</fpage>
         <url>http://www.jfootankleres.com/content/1/S1/K2</url>
         <xrefbib>
            <pubid idtype="doi">10.1186/1757-1146-1-S1-K2</pubid>
         </xrefbib>
      </bibl>
      <history>
         <pub>
            <date>
               <day>26</day>
               <month>9</month>
               <year>2008</year>
            </date>
         </pub>
      </history>
      <cpyrt>
         <year>2008</year>
         <collab>Arangio; licensee BioMed Central Ltd.</collab>
      </cpyrt>
   </fm>
   <bdy>
      <sec>
         <st>
            <p>Introduction</p>
         </st>
         <p>Biomechanical models have been used to study the distribution of foot forces, metatarsal stresses, heel pad, arch height, plantar aponeurosis, subtalar joint, extrinsic muscles, medial displacement calcaneal osteotomy, subtalar arthroereisis and lateral column lengthening calcaneal osteotomy in the normal and flatfoot. We review past research data and discuss results as they relate to relevant clinical topics. <abbrgrp><abbr bid="B1">1</abbr><abbr bid="B2">2</abbr><abbr bid="B3">3</abbr><abbr bid="B4">4</abbr><abbr bid="B5">5</abbr><abbr bid="B6">6</abbr></abbrgrp></p>
      </sec>
      <sec>
         <st>
            <p>Methods</p>
         </st>
         <p>A three dimensional multi-segment biomechanical model <abbrgrp><abbr bid="B7">7</abbr></abbrgrp> was used with anatomical data from normal feet, feet made flat and corrected feet. The model includes a series of equations that describe how the foot deforms under a theoretical applied load of 683 Newtons (70 Kg.) on one foot in static stance phase</p>
      </sec>
      <sec>
         <st>
            <p>Results</p>
         </st>
         <p>Lateral Column Lengthening Calcaneal Osteotomy (LCL) decreases the forces needed by ligaments to resist moments at the medial arch joints by -79% and the talo-navicular Joint -63% in the flattened foot.</p>
         <tbl id="T1">
            <title>
               <p>Table 1</p>
            </title>
            <caption>
               <p>Moments in Newton-meters (N-m)</p>
            </caption>
            <tblbdy cols="4">
               <r>
                  <c ca="left">
                     <p>Joint</p>
                  </c>
                  <c ca="left">
                     <p>Normal Nm</p>
                  </c>
                  <c ca="left">
                     <p>Flatfoot Nm</p>
                  </c>
                  <c ca="left">
                     <p>Flatfoot + LCL Nm</p>
                  </c>
               </r>
               <r>
                  <c cspan="4">
                     <hr/>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>1<sup>st </sup>Metatarsal medial cuneiform</p>
                  </c>
                  <c ca="left">
                     <p>0.20</p>
                  </c>
                  <c ca="left">
                     <p>8.76</p>
                  </c>
                  <c ca="left">
                     <p>0.51</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>Medial &#8211; cuneiform navicular</p>
                  </c>
                  <c ca="left">
                     <p>0.33</p>
                  </c>
                  <c ca="left">
                     <p>14.48</p>
                  </c>
                  <c ca="left">
                     <p>0.84</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>Talo-navicular</p>
                  </c>
                  <c ca="left">
                     <p>5.61</p>
                  </c>
                  <c ca="left">
                     <p>
                        <b>21.63</b>
                     </p>
                  </c>
                  <c ca="left">
                     <p>
                        <b>8.05</b>
                     </p>
                     <p>(-63%)</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>Calcaneal-cuboid</p>
                  </c>
                  <c ca="left">
                     <p>5.69</p>
                  </c>
                  <c ca="left">
                     <p>0.00</p>
                  </c>
                  <c ca="left">
                     <p>7.72</p>
                  </c>
               </r>
            </tblbdy>
         </tbl>
         <fig id="F1">
            <title>
               <p>Figure 1</p>
            </title>
            <caption>
               <p>Cadaver Foot with calibrated cage and pointer for Direct Linear Transformation Photography illustrating LCL</p>
            </caption>
            <text>
               <p>Cadaver Foot with calibrated cage and pointer for Direct Linear Transformation Photography illustrating LCL.</p>
            </text>
            <graphic file="1757-1146-1-S1-K2-1"/>
         </fig>
      </sec>
      <sec>
         <st>
            <p>Conclusion</p>
         </st>
         <p>The model has accurately predicted the deformation of the foot under a theoretical load of 683 Newtons. We have analyzed the effect of various surgical procedures on the flatfoot. We discussed the clinical relevance of the model data to the ankle sprain, 5<sup>th </sup>metatarsal stress fracture, posterior tibial tendon insufficiency, the flatfoot and the cavus foot.</p>
      </sec>
   </bdy>
   <bm>
      <ack>
         <sec>
            <st>
               <p>Acknowledgement</p>
            </st>
            <p>Eric P Salathe Sr. PhD.</p>
         </sec>
      </ack>
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</art>
