The operation to stop when a valgus deformity

A big risk of twisting of the feet is celebrated by the people, who have a tendency to articular pathologies and wear uncomfortable shoes. The disease, in which the bumps at the first phalanx of the finger, is called hallux valgus. Due to the deformation of the foot more often affected women. If you want to fix the curvature, it is necessary to remove the hallux valgus, the operation is carried out in 3-4 stages of the disease. The frequency of occurrence of pathology depends on the age of the person. Stop, will start to deform with long-term wearing shoes with high heels. The process takes several years. Change the width of the soles of the feet more frequently noted in middle-aged and older.

valgus deformation of foot surgery

Operative treatment of hallux valgus

Doctors note that the operation for the correction of the feet - this is a procedure without which it is impossible to do, if acquired large dimensions, and prevents walking. The bumps on the foot and hampering movement. The main sign of the progression of hallux valgus - it's a pain. Deformation of the feet is observed in people with flat feet and a long metatarsal bone. Treatment of diseases of the hallux valgus deals with the orthopedist. It helps to restore the normal position of the feet and prevent the overgrowth of bone.

THE STAGES OF THE DEFECTIVE PROCESS

The decision about: whether it should be made of the operation of hallux valgus, receives doctor. Draws attention to the degree of contortion of the feet. At the first 2 stages of the disease is performed conservative therapy. If the correction becomes impossible, requires a surgical procedure. Issue 4 degrees of severity of hallux valgus:

  1. The first phase of the. The angle of deviation metatarsophalangeal joint is not higher than 15 degrees;
  2. The second phase of the. It is characterized by the appearance of a small, but noticeable bumps. The angle of deviation is equal to 15-20 degrees;
  3. The third stage of the. What to stop is becoming more pronounced, the inflammation of the when walking and wearing tight shoes. The deviation of the joint ranges from 20 to 30 degrees;
  4. The fourth phase. Characterized by the pain syndrome and the development of complications. The angle of deviation metatarsophalangeal joint is higher than 30 degrees.

In the early stages of the disease the operation valgus deformity of the first finger of the foot is not necessary. In these cases, the problem can be solved without surgery. If the load on the legs will not fall, become the valgus curvature of the foot. With the progression of the disease, the thumb still more deviates inward, while the joint - outwards. In the result of the foot extends. In the later stages of hallux valgus is observed a constant swelling of the wound to a stop. Feelings of pain appear not only in walking, but still.

PREPARATION FOR SURGERY

INDICATIONS FOR SURGERY

After the execution of diagnostic procedures the orthopedist will decide: whether the operation to stop when a valgus deformity. Surgical treatment of curvature of the legs holding in the rejection of the joint by more than 20 degrees. Strongly convex hallux valgus on the stop by an adult will be held themselves. So, the operation when the deformation of the 3 and 4 degree - it's a matter of time.Expressed by the curvature of the founding of the soles of the feet in the absence of pain syndrome and inflammatory phenomena refers to the testimony for the surgery. If hallux valgus brings discomfort, then surgery valgus deformity of the big toe of the foot is necessary. Prior to the surgical treatment, conduct a series of studies.

Issue following indications to surgical intervention:

  • Frequent and severe pain in the area of the base of the thumb;
  • The development of inflammation when wearing the footwear;
  • Swelling of the thumb;
  • Flat feet;
  • The Absence of effect of conservative treatment;
  • The incidence of complications.

Flat feet is an indication of surgery

Before you proceed to treatment, the doctor and the patient discuss all "for" and "against" the surgery of hallux valgus. The patient should understand that a surgical procedure will help to avoid the dangerous effects of deformation. Complications valgus curvature of the foot include: the formation of ulcers on the surface of the fabric strain to the joint, infection of the bones, a violation of the walk.

CONTRAINDICATIONS TO OPERATIVE TREATMENT

There are cases when restore the shape of the foot during the humanitarian operations shall not be. These include serious diseases of the vital organs. Operation when the valgus deformation of the first finger of the foot is contraindicated, if it is in the patient are expressed changes in the analyses. Remove the bone is not recommended, if the angle of deviation of the joint is less than 20 degrees. The absolute contraindications to perform the operation of hallux valgus include the following conditions:

  • Violation of the coagulation of the blood system;
  • Decompensation of heart diabetes;
  • Acute failure of the cardiovascular system and the respiratory system;
  • Uncontrolled arterial hypertension;
  • Thrombophlebitis of the veins of the lower extremities;
  • Chronic illness pain of the joint system.

Thrombophlebitis - an absolute contraindication for surgery

They reveal the presence of contraindications after the execution of the biochemical and general blood tests, coagulogram and chest x-rays of the foot. Surgery may be disabled, but before its implementation should undergo treatment. Among the relative contraindications: acute infectious diseases and exacerbation of chronic inflammatory diseases.

METHODS OF SURGICAL TREATMENT

There are various kinds of operations of hallux valgus. The choice of a particular method of treatment depends on the degree of deformation and condition of the patient. Issue minimally invasive and open surgery. Depending on the stage of valgus deviation of the thumb, we distinguish the following methods of surgical treatment:

  • Manipulation of the soft tissues of the foot;
  • The proximal and distal osteotomy;
  • Operations Lapidus;
  • Joint Keller.

It is known about 200 species of surgical interventions on elimination of valgus deformation. All therapeutic treatments are aimed at the correction of the curvature of the metatarsal bone. The goal of each of the operations is the removal of a blister on the foot and relieve the patient from pain. How to restore the normal shape of the foot, solves the orthopedist.

To minimally invasive procedures include percutaneous intervention. They are excision of bone tissue. Recovery after valgus surgery of this type is happening quickly. Percutaneous removal of the bumps on the legs is indicated in cases where the curvature of the expresses the not too.

Manipulation of the soft tissues are dissection the muscles and ligaments of the foot. They are held in a small deformation, and also in cases where the intervention on the organs of the pain of the joint is contraindicated. One of the variants of the manipulation of the soft tissues is the operation of Mc-Bride.

Types of operative intervention

Osteotomy - this is a surgical procedure that involves the artificial fractures of the metatarsal bone and its fixation in the desired position. Depending on the severity of the valgus curvature is set to a certain technique of this operation.

Arthrodesis - this is the emphasis on the connections between the correct position. Applies when the deformation degree of 3-4. How to get rid of the seeds perform arthrodesis on the Lapidusu - this means that the joint is repaired in the correct position the special tools. To remove the hallux valgus is possible by means of operations of the Keller. It is resection of the affected tissue of the articular surfaces and the determination of the metatarsal bone. Her perform in rare cases, because the mobility of the thumb after this procedure, it is impaired.

Every operation is different, a special surgical technique execution. To remove the hallux valgus on the medpolis, it is necessary to stand on the site, and pass all the tests. The surgeon should agree in advance the operating tactics with the patient. The patient warn, on what day of the planned intervention and how long will it take to recovery period.

PREPARATION FOR SURGERY

Before, how to perform the operation, the doctor performs a training procedure. It lies in the implementation of diagnostic studies. For several days before the operation is to be performed:

  • Tool management of user accounts;
  • OAM;
  • Biochemical analysis of blood;
  • Coagulogram;
  • X-rays of the foot in the lateral projection;
  • Electrocardiography;
  • Tests for HIV, syphilis and hepatitis.

X-ray - a mandatory procedure

At the discretion of the doctor and the patient solves a question on the implementation of the relief from the pain. If it is planned to remove the bone a minimally invasive method, then perform local anesthesia. In the absence of contraindications and the patient's wishes to remove the bumps can be under a common anesthesia. Intravenous anesthesia carried out in those cases when it is scheduled to open surgery. Review on the surgery of hallux valgus in most cases positive. Virtually all patients note that he does not feel discomfort during the procedure, despite the local anesthetic.

OPERATIONS ON THE SOFT TISSUES OF THE

OPERATIONS ON THE SOFT TISSUES OF THE

Excision of the soft tissue of the feet is used as a treatment for a valgus deformity. The indication for this method of handling is used deviation of the thumb, less than 25 degrees. This method of treatment is often combined with other surgical procedures. To the varieties of procedures on the soft tissues of the legs include operations Mc-Bride.

Operations on the soft tissues (McBride)

Technique this surgical manipulation is dissection of the muscles, which leads thumb. Thanks to this procedure the bone takes the correct position. After the cut-off muscles is performed to remove the capsule of the joint from the lateral side. Tendon hem to the head of the metatarsal bone. This procedure leads to robust fixation of the thumb. Rehabilitation after surgery of hallux valgus lasts for several months.

TECHNIQUE ARTHRODESIS

A possible method of treatment of valgus deformity - this is an operation Lapidus. This means arthrodesis metatarsophalangeal joint. If you want to fix the curvature of the carrying out of the relocation of the cartilage. The joints between the attached to the physiological position and fix it using the special plate.

Joint on the Lapidusu

Orthopedic shoes after the surgery of hallux valgus worn for a period of 8 weeks. Requires special shoes, which help reduce the load on the front of the front legs. Joint replacement in Keller practically applied.

THE PROXIMAL AND DISTAL OSTEOTOMY

Osteotomy performed in a significant deviation of the thumb of the foot. The essence of the operation consists in the implementation of the fracture of the bone, followed her a push in the right direction. Distal osteotomy of the Chevron is applied most often. Is made V-shaped fracture of the metatarsal bone. Then they performed a lateral offset and determining the compression with the screws. Surgical suture are removed after 2 weeks. All patients demonstrated exercise therapy and massage the legs after surgery for hallux valgus.

Osteotomy (V - and Z-shape)

The proximal osteotomy is performed using a preparation of the tissues of the legs from the base of the thumb into the metatarsal bone. This method operate, if the deviation is greater than 40 degrees. After the cut tissue to produce a Z-shaped incision of the bone, and then carry her bond titanium with screws.

THE PROXIMAL AND DISTAL OSTEOTOMY

COMPLICATIONS AFTER SURGICAL TREATMENT

In rare cases there are complications of the operation. They can occur on the fly surgery or in the recovery period. The possible complications include:

  • Damage to the nerves in the legs;
  • Thrombosis of the arteries and veins of the foot;
  • Injection of the tissue of the foot;
  • Aseptic necrosis of head of the metatarsal bone;
  • Numbness of the thumb.

That the post-operative period was successful, it is important to follow all recommendations of the doctor. The activity of the joint is restored gradually, so the load should be minimal. After the seams of the bones of the proven therapeutic exercise. The cost of the operation in the valgus deformity of the big toe the foot depends from the varieties of surgical procedure. It is in the range from 20 to 55 thousand rubles.

CONVALESCENCE

To the result of the operation was good, in the early days of the station to be recorded in one location. In the first days of the operation in the legs limit. After remitting pain syndrome prescribe a foot massage.

That joint came into force, it is necessary to develop in the course of a few months. For this purpose, all patients are recommended complex of special exercises. Gymnastics is allowed only after 3 months after surgery. By this time the joint of the developing assistance in the implementation of passive movements and massage. Exercises for the fingers the legs after valgus operations are carried out in the course of a few months. They should not put more pressure on the joint. Gymnastics is flexion and extension of the thumb, the tension of the muscles of the foot. Rehabilitation time is about six months. After 6 months, the patients returned to normal physical activity.

Medical gymnastics

CONVALESCENCE

To restore the function of the foot in patients wearing orthopedic shoes with special insoles. it Is necessary to base load distributed on the rear department of the foot. Orthopedic insoles after surgery stop is recommended to wear a few months to full recovery.

09.08.2018