In the article, we discuss the work of Valgus deformation on the first toe of the foot, indications and contraindications for its implementation.You will find out what types of surgical elimination of bone exist, how rehabilitation goes, what complications are possible.The work of Valgus deformation on the first toe of the foot.Indications for the work of Valgus's deformation.The disease, called Valgus deformity, is known to many - this is the formation of a convex bone of the thumb of the foot.In addition to aesthetic unattractiveness, this pathology brings significant suffering, is dangerous from the development of irreversible changes in the first plus-phalang of the foot of the foot to its complete destruction.
In the early stages of development, conservative methods are used - orthopedic correlators in combination with baths and ointments. If such therapy does not result, a person with Valgus deformation prescribes surgery for deformation of the valgus of the thumb. Its type depends on the degree of development of the disease, the age of the patient and the presence of other common and local diseases, as well as the causes that cause degenerative changes in the joint.Indications when surgery is needed:
- The ineffectiveness of conservative therapy methods.
- 3 and 4 stages of pathology with inflammation and severe pain.
- Degenerative tissue lesions.
Depending on the stage in which the joint tissue resides, the orthopedist surgeon chooses the type of operation with a deformation of valgus from 1 finger.
Types of Valgus deformation operations
When the thumb thumbnail is diagnosed, the operation is used to expose only soft tissues and tendons, to correct a defect in bone tissue or with a combined effect.There are more than 3000 types of surgical elimination of the bone - from easy correction and so - called minimally invasive interventions to cutting of joints and even the whole joint with an artificial endoprosthesis substitute.In addition to the degree of damage to the plus-phalanga of the joint, when choosing a Valgus deformation operation of the first finger, the patient's general condition and the presence of other diseases are taken into account.Removal is performed under local anesthesia or under general venous anesthesia - when choosing the patient.
McBride
McBride surgery, other names: silver work, tendon transposition, refers to minimally invasive interventions affecting only soft tissues. In the process, the surgeon moves the tendon of the removable muscles of the thumb to the head of the bone I plus.As the whole muscle balance of the foot changes, and I and II, the metatarsal bones are approaching due to the formation of adhesion of the dialing muscle, it cannot withstand the overload of the foot, and the recurrence of the disease occurs very often.In fact, this operation only temporarily eliminates the pain and stops the development of deformity.
Serry
Serial osteotomy also refers to sparing interventions, it is a short duration. In the process, the distal cutting of the distal metaphies of the first plus bone (cones) is performed with a larger fixation of the bones by knitting a needle, which is placed through the thumb. A special shoe was then appointed for the rehabilitation period.Seru work of Valgus deformation of the first toe of the foot, according to the examinations, gives a noticeable result, the postoperative period is short after you can switch to ordinary shoes.The effect is long, the likelihood of relapses is low.
Shevron
Chevron or Chevrony V-shaped osteotomy (Chevron osteotomie) or-minimally invasive surgery used only with small deformities (the angle of shift of the thumb up to 17 degrees) and without concomitant pathologies (arthritis, arthrosis). Two small cuts are obtained in the process, the ligaments and the joint capsule are displaced, the bone corn is removed, then the phalanx is fixed with the help of a titanium wire or a titanium screw. If necessary, the wire or screw are removed after 3 months.The whole operation is performed under the control of EOP-RANTGEN.The efficiency of the operation is high, the recurrences rarely occur, but due to the complexity of the intervention itself and the requirements for a very high qualification of the surgeon, it is rarely used.
Scarf
The osteotomy of the scarf (scarf, Z-shaped) is used for moderate and severe deformity of 1 plus bone on the foot, with an angle of slope of the toe up to 40 degrees. The process is carried out through a cut from below the foot to the base of the plus bone.There is a wedge with a Z-shape and the phalanx head is shifted to the correct position.At the same time, the position of the tendons and the capsule of the joint. This position is fixed with two miniature titanium screws.In most cases, they are not extracted as the patient does not experience any discomfort.In surgery, this is the most commonly used surgery to diagnose valgus deformation of the thumb of the foot.Reviews speak of rapid healing after surgery, minimal scarves, short rehabilitation period.The effect is excellent, long -term, the relapses are extremely rare.
Valgus deformity arthrodesis
Arthrodesis or lapidus surgery - the closure of the medial joint is used in severe complex deformities, which are accompanied by particularly high joint mobility.This is a radical operation in which complete immobilization of the plus-clinical joint is performed. To do this, the bones that form it are tightly connected to 2 titanium screws with a special shape in the longitudinal position. This complex operation is only used if other types cannot produce a positive result.After arthrodesis, the deformity is completely eliminated, the manifestations of arthrosis and soreness disappear.The immobility of the joint does not affect the patient's gait, but it is impossible to wear heeled shoes.Gradually, with the use of drug therapy and physiotherapy, the structure of the joint and foot is completely restored.The results are positive in 98% of cases.According to the reviews, the radical deformation of the valgus of the thumb of the foot with the operation of the arthrodesis allows you to restore the functions of the foot even in advanced cases
Finger deformity
Apply for different degrees of deformation of 2-5 fingers, depending on this type of surgery is chosen.This can be closed violent unacceptable removal of joint contractures and axial deformities of the limbs by stretching and partial rupture of the soft tissues, modeling or complete resection of the heads of the metatarsal bones and phalanges, moving (transposition) and crossing (nor standing the boot,(ostelotia).The correct position of the fingers is fixed with the needles or screws of Herbert.The desired result can be achieved for a long time in 85% of the interventions of curved fingers.Pain and discomfort when wearing shoes reduce or completely disappear.Valgus correction deformation of the toes of the foot with surgery of this type gives a good cosmetic result.Statistics have been found to have no more than 2-3% of surgery.The forum dedicated to the deformation of Valgus of the thumb of the foot is fraught with reviews of the effectiveness of cones removal operations.
Rehabilitation after surgery
The postoperative period is divided into several periods.The rest of the bed in the clinic lasts 2-3 days.Already 5-6 hours after the surgery begins the development of the legs - the fingers move.From the third day you have to get up and walk using the special Barok shoes and then orthopedic orthosis, which remove the load from working joints.In some types of surgery (arthrodesis), hospital time may be extended to 10 days.The second stage is the healing and restoration of the maintenance function of the leg.It lasts from 3 to 6 months.At this time, swelling of the foot and ankles may remain.To relieve the condition, you need to relax with your legs raised.Cool grass compresses are also effective.A month - two, on the recommendation of a doctor, you will need to walk with crutches so that the joint does not suffer from the load.Until the seams are healed, water procedures must be performed by protecting the foot with a plastic plastic bag.Physiotherapists are also prescribed: electrophoresis, shock wave therapy.The massage begins to be used not earlier than a month after surgery and physiotherapy exercises - after 2 months.Most often it is the development of the foot, an exercise motor, swimming.In order to maintain the joint in the correct position, it is necessary to use a heavy night tire Valgus.Orthopedic shoes are worn during the day, the term is at least 3 months.Wearing a heel is allowed not more than 6 months after surgery, a height of no more than 4 cm. Sport can start only 6 months after the deformation is eliminated.
Contraindications to surgery
The restrictions on surgical treatment of the legs of the legs are not very extensive:
- Pathologies of the vessels of the limbs - varicose veins 3 and 4 degrees, thrombosis, deletion of atherosclerosis;
- Diabetic leg;
- Oncology;
- Purulent infections and acute inflammation.
What to remember
- In the bones of the legs, surgery is prescribed if conservative methods do not help or the disease is started.
- The efficiency of the operations is high, the complications are rare.
- The earlier you start treatment, the easier the surgery and rehabilitation is.