The transverse arch in the human feet: A narrative review of its evolution, anatomy, biomechanics and clinical implications - 22/11/22
L’arche transversale du pied humain : une revue narrative de son évolution, de son anatomie, de sa biomécanique et de ses implications cliniques
Highlights |
• | Transverse arch a critical structure in erectile posture and movements which primarily provides a dynamic support, appropriate rigidity and elasticity during various phases of gait. |
• | It acts like shock absorber, modulator of elastic energy, and quickly adapts to external stimuli and athletic need. |
• | The midfoot likely plays an important role in modulating the rigidity and elasticity of the foot. |
• | Transverse arch is a stiff spring lever which provides more than forty per cent of foot stiffness. |
• | The foot stiffness helps the intrinsic elastic structures of the foot to store energy which is utilized during propulsion of foot. |
• | Transverse arch modulates longitudinal arch biomechanics, and makes it stiff or flexible as per the need of the surface of the terrain. |
Summary |
The dominant characteristics of the human foot are its shock-absorbing capability during walking or gait cycle and its adaptation to uneven surfaces. On the stance phase of the gait, the foot has to be flexible at first for shock absorption and adapt to the terrain; whereas, during the propulsive phase, it has to be dynamically rigid to function as a lever. Foot flexibility and rigidity are mainly controlled at the subtalar and midtarsal joints by tendons and ligaments. The subtalar joint is part of the longitudinal arch, but the midtarsal joint along with the tarsometatarsal joint are components of the transverse arch. However, the existence and functional role of transverse arch in human was challenged by some authors. But recent studies have revealed that the transverse arch has a predominant role in midfoot stiffness (Venkadeshan et al., 2020, & Holowoka et al., 2017). This midfoot stiffness allows the human foot to store elastic energy at the time of heel strike, which is utilized during the push-off mechanism for propulsion, thus making bipedalism more energy-efficient. Moreover, the transverse arch allows the longitudinal arch to be flexible like a lever and, at the same time, makes the arch of the foot rigid to behave like a stiff spring lever. Understanding the role of the transverse arch is obligatory to study the biomechanics of foot injuries and Charcot or diabetic foot. Studies on diabetic foot have shown that the modulation of transverse arch biomechanics and off-loading modalities would improve outcomes in the form of wound-healing and prevention of re-ulceration.
Le texte complet de cet article est disponible en PDF.Keywords : Diabetic foot, Subtalar joint, Gait, Foot injuries, Wound healing
Plan
Vol 106 - N° 355
P. 225-234 - décembre 2022 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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