Transcutaneous surgery and other methods of repair вальгусной deformation

The term hallux valgus deformation indicates a deformation of the joints of the hock/the phalanx of the first finger of the foot, which is manifested by a slope of the last party to the other fingers, at least 8°. The first toe (large) displaced from its normal position and deviates in the direction of the other toes, sometimes even overlaps the second and even the third finger.

The problem manifests itself with severe abdominal pain, concentrated in the sole, which in many cases can seriously affect the walking. And in addition, deformation of the joint over time deteriorates and may reach such a level that the use of standard footwear is becoming problematic.

Surgery is the only treatment in the advanced stage

The methods by which the operation can be performed, and, of course, the choice depends of the functions of the patient and the causes of the disease.


The selection techniques of the operation have the effect of the following parameters:

  • The age of the patient. Young patients are recovering more quickly and completely.
  • The physical condition of the patient. Evaluation is necessary for selecting the type of anesthesia.
  • The scope of activities and expectations of the patient, in terms of restoration of function of the foot.
  • The size of the degradation of bones, joints and soft tissue: tendons, cartilage, joint capsule.

It is obvious that to carry out the evaluation the doctor will also rely on a variety of clinical examination: general physical examination, performing cardiac tests, blood work. You will need some local tests, such as x-rays of the feet, for the evaluation of the extent of deformation. And yet will need to view is an anesthesiologist for choosing anesthesia.

Anatomy of the thumb

The fingers are composed of segments of bones, the phalanges, usually 3 for each finger: проксимальная фаланга, medialis фаланга and distal фаланга. The thumb consists of two phalanges: proximal and distal (missing media).

The aim of the operation – the result

A surgical procedure for the treatment of вальгусной deformation aims to:

  • The "rebuilding" of the thumb with the metatarsal area of the bone, and therefore, reduction of the valgus angle.
  • The reduction of the angle between the first and second metatarsal area of the bone.
  • The restoration of joint function.
  • Removal of wounds, and corns, which are formed on the side of the head of the first metatarsal area of the bone.

The methods of intervention that are open and transcutaneous surgery

Traditional surgery

As usual, the traditional surgical approach in the treatment of вальгусной deformation is used in very young patients or in patients with significant disorders of the joints.

In this operation they make incisions, large enough to open access to the surgeon.

Rules of operation:

  • Остеотомия (resection) of the head metatarsal area of the bone in the most appropriate form (L-, V-, "dovetail", and so on), to get the best alignment of the phalanx.
  • Остеотомия phalanx to complete the alignment.
  • The liberation of the sesamoid bones in any adhesions.
  • Tendon replacement head muscles of the thumb.
  • Replacement of the joint capsule and its consolidation with the trimming of the cloth.
  • Inserting one or more studs, if desired, to add stability.

If the affected joint has arthrotic degeneration, during the operation, the surgeon will assess the condition of the cartilage. If possible, issue a replacement of any osteophytes'. In the opposite case, it will be recorded so that it can be walking, despite the stiffness.

Mini-invasive surgery

This form of intervention takes place very quickly (a few minutes, maximum is 10), which, of course, requires less time for recovery after surgery. Its disadvantage is that the doctor has more discretion and can not affect the surrounding soft tissue.


For this reason, intervention is indicated only for the young or very young patients, because they have a lot of potential.

Transcutaneous surgery

The procedure is similar to the previous, but use miniature surgical instruments controlled from outside, under control through x-ray.

This type of operation allows you to intervene into the soft tissues. Also, of course, in this case, it is important skill of the surgeon. Despite this, it is obvious that the risk of such an operation are very low, but not zero. Rescue here also goes very quickly.

Anesthesia and послеоперационное rescue

All the described operations are carried out under local anesthesia. Mini-invasive and чрескожные interventions are performed on an outpatient basis with the return home after a few hours.

Regardless of the method, it is very important to proper recovery after surgery, which begins right after surgery, using a special rehabilitation exercises they do with the use of a special shoe, which allows the patient to walk for the second day after surgery.