Types of surgical intervention in the Halus valgus

valgus deformation of the

Valgus deformation of foot (Halus valgus) – the pathological transformation of the first metatarsophalangeal joint. In the development of the disease due to the thumb deformed by the other fingers of the foot. At the beginning of the therapy are widely used all kinds of orthopedic devices. In cases where conservative medicine is powerless, there is shown a surgical procedure. Operations Halus valgus eliminates severe deformity of the forefoot. The type of surgery depends on the severity of the disease and the presence of associated diseases.

The causes of the disease

Halus valgus brings discomfort when walking and spoils the appearance of the legs. In addition, the disease is able to disturb the blood circulation, provoking the emergence of bursitis and arthritis. The incidence of Halus valgus may cause:

  • Disorders in the endocrine system;
  • The weakening of the ligaments;
  • Ptosis longitudinal and transverse arch of the foot;
  • Age destruction of tissue bone;
  • Genetic location.

The medical practice will find plenty of confirmation that the Halus valgus more frequently observed in women, prefer shoes and boots on high heels. Often stop, for the representatives of certain professions, for instance the ballerinas. The observed and "nepotism" Halus valgus – often mothers and grandmothers of patients also suffer from a similar deformation. In men the ligaments elastic and firmer, so Halus valgus in them diagnosed for the most part after the injury.

The symptoms of Hallux valgus

symptoms

The early stage of the Halus valgus own stiffness and discomfort when walking. The progression of Hallux valgus is often accompanied by bursitis – inflammation of the mucous bags in the area of the joint, aggravantes the course of the disease. In addition, there are joint pain when walking and sometimes at night. They are different in severity, from barely visible up to unbearable, cutting, or long, sore.

Stop losing the depreciation function. The further course of the disease is able to induce changes in the intervertebral disc and produce symptoms, degenerative disc disease, joint arthrosis. Pain whining character in this stage is Halus valgus appear in the spinal rod. While without moving, when the patient is feeling flowing in the limbs and severity, and on the movement of the load – pain.

At the same time, the joint enlarges. Increase, it smooths the synovial folds. As a result of the cartilage thinner, while bones made do not affect each other. Abrasion of the joint surfaces causes the formation of osteophytes – pathological growths tissues of the bone.

The development of the disease

The gradual development of Halus valgus often enables you to diagnose the disease at an early stage, when abnormal disorders can be cleaned using traditional therapy and the use of special products. Small seal at the base of the thumb, the feet often believe corn and trying to get rid of traditional methods. But in time "'with the fingers on the feet", more hardens and grows even more, causing pain when moving.

Excessive load, which is exposed to the joint, causing inflammation of bone tissue. When the thumb pushes on the angle more than 30°, deformed fingers on his feet. Podiatrists divide during the Halus valgus into three stages:

  • Also – the finger is shifted to the outer edge at an angle of at least 25°, the instep bone inside – the angle is less than 12°;
  • II – the finger is shifted to the outer edge at angle of 25°, the instep bone inside – the angle is less than 18°;
  • III – the finger is shifted to the outer edge at an angle of more than 35°, the instep bone inside – the angle of 18°.

Important! The degree of changes in the structure of the foot – the main factor in deciding on a method of surgical treatment of Halus valgus.

Indications for surgery

The main indications for surgical therapy Halus valgus – pain syndrome, the emergence of inflammation and injury to the tissues of the bones. Hallux valgus is possible to treat the traditional ways to the completion of the formation of the skeleton – only in children and adolescents. In an adult patient during the disease can only slow down: stop the pain, to restore the pressure on the specific department of the foot and prevents the development of complications.

methods of treatment

Solve the problem with the Halus valgus allows the surgical treatment. Plan of operation Halus valgus to stop being developed under the particular ill – diseases are own all sorts of speeches and accompanying complications.

Types of surgical interventions

The selection of a method of performing a surgical procedure, the influence of the nature of the disease, the extent of negative changes in the tissues, the presence of serious contraindications. There are more than three hundred kinds of surgical interventions in the Halus valgus. All are divided into basic groups:

  • Affecting the soft tissue;
  • Acts on the bone;
  • Combining the manipulation of the soft tissues and bones.

Earlier in the surgery of Hallux valgus excised the articular head. Similar traumatic impact was subsequently impaired function of the legs. Now orthopedic surgeons prefer to do minus traumatica of the operation.

Sparing technique

Minimally invasive operations are displayed on the first stages of pathological processes. Assume the handling, slightly acts on the soft tissue and also tendon. The aim of sparing methodologies – the reconstruction of the aesthetics and the removal of unpleasant sensations while driving. These operations allow patients to recover quickly. But they remain the risk of development of hallux valgus violations in the future.

In the course of the operation are two of the injection (3-4 mm), on both sides of the first finger of the foot. Using microtools, open joint bag, which is when the disease is often compressed. Its extension through a miniature incision giving a space for setting the axis of the finger to the physiological position. For the complete removal of the curvature of the finger some of the bone rasp micro caedentes. In the implementation of the manipulation used x-ray control. Special brackets are not used.

Reconstructive surgery

removal

During this kind of surgical interventions produce a longitudinal cut of a length of 2-4 cm in the area of the lateral plane of the legs. Big finger to introduce into physiological position. The bone of the game result in a remove, in the area of the completion of the joints of the toes and ankle and to restore of the bunch.

On the instep bone works in a number of ways:

  • Austin, this is the same herringbone (dissection of a V - or L-shaped) – for small offsets of inches (less than 17°);
  • Scarf (dissection of the Z-shaped) – in medium and heavy forms of deviation of a finger (from 17° to 40°);
  • Akin (dissection wedge) – often combined with minimally invasive methods.

After the osteotomy of the bone fragments are secured by compression screws made of titanium. They usually do not require extraction. When the problems of the titanium brackets removed outpatient later, three months after surgery.

Arthrodesis

This way – it is radical surgery, while Halus valgus on the background of arthrosis. When it is created by a fixed articulated arm. The zone will be disposed of and painful, and morbo articulari laborans manifestations, and itself deformation. The lack of joint mobility the impact on walking of the patient and his activity.

Apply arthrodesis if other methods of treatment Halus valgus did not bring the expected result. When operative intervention fragments the completion of the joints tightly connect the special screws. Before install the bolts removed from the surface of the first joints of the hocks and the head of the proximal phalanx of the first finger. The physiological structure of the foot is recovering, the symptomatology of arthrosis disappear.

Contraindications and complications

All surgical manipulation is absolutely contraindicated in:

  • Serious pathologies of the blood vessels of the extremities (obliterating atherosclerosis);
  • Diabetic effects on the peripheral nervous system (diabetic foot);
  • Festering infection;
  • Pathologies of the hematopoietic organs.

When osteoarthritis and arthritis surgical treatment feasible. But, selecting a way to perform operations Halus valgus, do take into account the occurrence of possible complications – both during the actual surgical procedure and recovery period.

After operations Halus valgus reconstructive kind of complications can arise, associated with an open cavernous interventions:

  • Infestation of tissues;
  • Blood clots in the deep veins;
  • Aseptic necrosis of head of hock (occurs very rarely);
  • Restrictions on the functional performance of the first finger;
  • Violation of the nervous bundles;
  • Swelling of allergic nature;
  • Numbness of the extremities.

The complications are observed rarely. Usually patients after surgery feels well and is in young and middle-aged.

rescue

Rescue

After the rapid intervention, patients prescribed bed rest. On the first day allowed to gradually evolve step – initially to wiggle your toes. On the third day, you can a little as the hon. The doctor will tell us what exactly it is necessary to wear after surgery Halus valgus. At first the pores – the only orthopedic accessories (brace), which eliminate the burden with the exposed exposed part of the forefoot. Under the supervision of a physician in the hospital is the patient from 10 days to 14 days.

Taking water procedures until removal of the stitches, it is necessary to roll up the step polyethylene. Bandages cannot be a shift and erase, otherwise you may experience a relapse of the disease. Walk without orthopedic products is permitted no sooner than six weeks. In the area of the legs and the lower flag of the ankle joint within three months after the surgery Halus valgus may persist swelling. Their peeled cold compresses.

For a quick restore function of the foot and healing atzastavitration wounds, is used:

  • Massage;
  • Electrophoresis;
  • The procedure of shock wave therapy;
  • Exercise health physical education.

Two months after performing the operation Halus valgus patient may recommend preventive swimming and an exercise bike. Complete rehabilitation after surgery Halus valgus lasts four to six months. However, from time to time step it is necessary to register on the above title. Work its not worth it. At night you can use corrective line. After surgery Halus valgus is recommended to perform the massage of the arch of the foot the ball for tennis.

Postoperational rehabilitation will speed up the special boots, designed for the fixation of the joints of the foot and are not providing to them the repressive effect. Wear similar shoes, need at least three months. On the narrow uncomfortable shoes and high heels is better to forget.

Important! When you need to perform a surgery on both legs is recommended to perform it with a break for three to six months.

After handling Halus valgus modern methods of patients almost immediately walk. But it is very important to entrust the implementation of an operation by a qualified specialist and to perform all of its recommendations in atzastavitration period.

11.09.2018