Hallux valgus - types, symptoms, treatment, massage. Hallux Valgus - hallux valgus (bone on the big toe)

Hallux valgus is the most common orthopedic disease. Its main symptom is the curvature of the 1 metatarsophalangeal joint. In the early stages, it appears as a small growth near the thumb. Pathology is characterized by slow development, so it is quite difficult to diagnose it at the initial stages. In the future, the patient begins to experience pain when walking.

Valgus deformity is often combined with impaired blood supply to tissues, which leads to the development of arthritis or arthrosis. If left untreated, an acute inflammatory process occurs in the joint of the thumb, called.

What contributes to the curvature of the finger?

The causes of hallux valgus can be different, the main among them are:

• flat feet;
• congenital pathologies of the metatarsophalangeal joint;
• muscle weakness, leading to pathological mobility of bone surfaces;
• leg injuries;
• cartilage destruction due to arthritis or arthrosis.

Wearing uncomfortable shoes is not a direct cause of the disease, but it can accelerate the development of the pathological process. Therefore, hallux valgus is most often found in women.

There are other pathological reasons why the first toe may be bent. develops when calcium is leached out of the bones, causing them to become less dense. This is what leads to a change in the shape of the joint. Almost every person who has symptoms of hallux valgus has one of 2 types of flat feet. Endocrine disorders contribute to a decrease in the strength of the ligaments, which is why they cannot hold the joint in the correct position. The risk group includes women who are used to walking in high-heeled shoes. The provision of increased loads on the toes accelerates the process of curvature of the joint.

Ballet dancers are forced to stand on their toes for a long time, which can lead to deformity of the feet. It is believed that the risk of developing the disease increases as the body ages. Thus, hallux valgus is found in only 3% of people under 30 years old, while among the elderly every 5 people have a similar problem. This disease is most often found in patients whose parents had pathologies of the musculoskeletal system.

Clinical picture of the disease

The curvature of the big toe in the initial stages is quite difficult to notice. A person notices that it becomes uncomfortable for him to walk in his usual shoes. After a long stay in a standing position, pain occurs. Over time, the main sign of pathology appears - the deviation of the first metatarsophalangeal joint towards the second with the formation of the so-called bump. The remaining fingers take the form of hammers. The patient may experience chronic fatigue and difficulty fitting shoes. Over time, corns appear on the skin of the feet, bringing a lot of inconvenience to a person.

The most common signs of hallux valgus are pain associated with inflammation of the synovial membrane. A soft seal appears in the area of ​​\u200b\u200bthe first finger. The skin of the affected area turns red and swells. The shape of the thumb is changing. Over time, a callus forms, irritating soft tissues. There are severe pains while walking. The mobility of the joint is limited, the pathological process can cover all the toes.

There are several degrees of hallux valgus, each of which has its own symptoms:

1. Hallux valgus 1 degree is characterized by a curvature of the finger by no more than 20 °. Pain is not observed.
2. With a disease of the 2nd degree, the joint is displaced by 21-30 °. Unpleasant sensations are mild in nature, the mobility of the finger is not disturbed.
3. With valgus deformity of the 3rd degree, the angle of curvature exceeds 30 °. Pain in the affected area becomes permanent. They prevent a person from wearing habitual shoes, walking and playing sports.
4. At stage 4 of the disease, the joint is displaced by more than 50 °. Deformation of this degree is characterized by severe pain, difficulties with choosing shoes, and the formation of calluses.

How is this disease diagnosed?

To establish a preliminary diagnosis, an examination of the foot and the collection of anamnesis are performed. The physician must:

• assess the severity of changes in gait;
• the degree of curvature of the joint;
• the presence of corns;
• bone lump.

Confirm the diagnosis with the help of X-ray examination in several projections. Computer plantography is a procedure in which the patient's foot is placed on a platform, the correct distribution of the load is determined by the nature of the print obtained. With the help of podometry, early signs of hallux valgus are detected. When making a final diagnosis, it is necessary to exclude diseases such as osteoarthritis and gouty arthritis. How to treat hallux valgus deformity of the big toe?

Main therapeutic measures

The choice of one or another technique depends on the degree of joint deformity and the severity of the pain syndrome. The most effective treatment for valgus deformity of the big toe is in its early stages. Therapy can be both conservative and surgical. In addition, wearing orthopedic shoes helps to stop the development of the pathological process, which contributes to the correct distribution of the load and prevents the appearance of corns. To reduce pressure on the affected area, special insoles and pads are used.

With a disease such as hallux valgus, treatment involves the use of anti-inflammatory drugs. Intra-articular injections of glucocorticosteroids help to quickly get rid of the pain syndrome. The drugs of this pharmacological group include:

• Kenalog;
• Diprospan;
• Hydrocortisone.

Due to the large number of side effects, these drugs are not suitable for long-term use. Drug therapy cannot completely rid a person of hallux valgus. With its help, you can only eliminate pain and signs of inflammation.

For the treatment of the disease, physiotherapeutic procedures are often used - diathermy or ultrasound. However, these methods provide only temporary relief. The most effective is the use of orthopedic devices, which are made taking into account the individual characteristics of the foot. The use of arch supports in the early stages of the disease prevents further deformation of the joint. With advanced forms of the disease, orthopedic devices make walking more comfortable. With the help of special insoles, you can eliminate the main cause of the curvature - flat feet.

Prevention of hallux valgus is a constant visit to the orthopedist. Wearing tight shoes with high heels should be avoided. The use of orthopedic insoles is recommended. Prolonged standing is prohibited.

Valgus deformity is a rather serious disease that can worsen the patient's quality of life, so treatment should begin in its early stages.

Halus valgus is an unpleasant and painful disease. Often it is preceded by transverse flat feet, but it can also develop under the influence of other factors: excess weight, wearing uncomfortable shoes, excessive loads on the legs. In the early stages, the disease is cured by conservative therapy, but in the last stages, surgery cannot be avoided.

Hallux Valgus (from Latin hallux - finger, valgus - deviation) is an ailment that is characterized by a pathological deviation of the big toe. Women are often affected by this pathology, but it can occur in men and even in children. The disease is characterized by the expansion of the forefoot and the elevation of the head of the big toe above the surface of the skin of the leg.

At stage I of the disease, redness and thinning of the skin in this area is observed, but over time, due to progressive bursitis and mechanical injuries, it coarsens. Due to the slow deviation of the first finger, it first subluxes, and then dislocations with entry under the second phalanx. Further, corns and corns are noted on the sole, which hurt, disfigure legs and hinder human movement.

Causes of pathology

Such a disease occurs for various reasons, but the hereditary nature of the pathology is often noted. The disease usually affects women. It is believed that this state of affairs is facilitated by wearing uncomfortable and even unhealthy feet shoes with a narrowed or excessively shortened toe and high heels. Nevertheless, not always an increased load on the legs, in particular, on the feet, leads to.

A significant provoking factor can be called failures in the endocrine system, to which women are more susceptible. Problems in this area can arise against the background of emotional overload, stress, and also due to certain changes in a woman's life (puberty, menopause, pregnancy).

So, hormonal metamorphoses can lead to the development of osteoporosis, weakness and loosening of bone and connective tissue, which can provoke changes in the biomechanics of the foot. Another important factor in the development of hallux valgus is excessive body weight and the presence of transverse flat feet.

Hallux valgus, the symptoms of which at first come down only to the rapid fatigue of the legs after walking, their pain, redness and swelling of the first metatarsophalangeal joint, as well as its bulging, is also dangerous because diseases such as arthritis, arthrosis, joint bursitis develop against its background . With further development, the disease acquires other signs. These include: an increase in the size of the protrusion of the finger; the thumb leans inward more and more intensively; there is a curvature of the other toes; soreness and inflammation continue to increase.

Stages of the disease

There are certain stages in the development of the disease. As a rule, the degree of deformation in case of an ailment is determined by measuring the angle between the 1st finger and the 1st metatarsal bone. A particularly important indicator for identifying the stage of the disease can be called the intertarsal angle (between the 1st and 2nd metatarsal bones).

Based on the measurement of this angle, 3 stages of hallux valgus are distinguished:

Stage I: the inter-tarsal angle is less than 12 degrees, and the angle of deviation of the thumb is less than 25 degrees;

Stage II: indicators are less than 18 degrees in the first case and more than 25 degrees in the second;

Stage III: more than 18 degrees and less than 35 degrees, respectively.

Diagnosis and treatment of pathology

If hallux valgus is suspected, especially if the presence of stage II and III of the disease is suspected and surgical treatment of hallux valgus is planned, examinations are prescribed to help verify the diagnosis and identify the stage of the disease. For this purpose, the doctor may prescribe X-ray, CT and MRI. However, the main method of diagnosis is still X-ray.

X-ray helps to see subluxation or dislocation of the first phalanx, divergence of metatarsal heads, and bursitis. All further treatment will depend entirely on research indicators.

Conservative treatment

As a rule, at stage I of the disease, its treatment is reduced to conservative therapy, which includes the following steps:

• making changes in lifestyle (weight loss, physical education is connected);
• orthopedic shoes are worn to eliminate interaction in zone I of the metatarsophalangeal joint;
• special insoles and arch support are used, which correct the arch of the foot;
• orthopedic orthoses for thumbs are used;
• wearing interdigital pads;
• night bandage is practiced.

Therapy with medication often comes down to taking NSAIDs and physiotherapy. In addition, treatment without surgery may include sessions of shock wave therapy. Nevertheless, with the low effectiveness of such treatment, as well as at stages II and III of the disease, a prompt solution to the problem is proposed.

Surgery

Now there are many methods of surgical correction of pathology, which indicates the seriousness of the problem and the absence of a universal method for treating this disease. At present, any self-respecting clinic offers the following main types of operations: laser exposure; traditional operation; endoscopic intervention.

Both laser exposure and endoscopic intervention are a minimally invasive operation, which is characterized by low blood loss, almost imperceptible traces of the operation, a short postoperative period and quick rehabilitation. Often, in both cases, the operation itself takes place under local anesthesia. Moreover, when using a laser, the very possibility of infection during the operation is excluded, since there is no contact between the instrument and tissues as such. Therefore, an increasing number of specialists prefer just such a pathology-correcting method.

If we talk about the traditional operation, then it still takes place. You can operate under both local and general anesthesia. First, a small incision is made and the bone growths in the area of ​​the metatarsus are eliminated, after which the correct angle of the metatarsophalangeal joint is created, to fix which a separate device is used. Further, the "bump" is eliminated in the same way. In total, this operation takes about one hour.

rehabilitation period

As a rule, after a traditional operation (when exposed to a laser and endoscopic intervention, the rehabilitation period is much shorter), a person stays in the clinic for another 2-3 days. It depends on the general condition of the patient and the severity of his illness. Subsequent recovery after surgery takes place at home. The sutures are removed 1-2 weeks after the intervention. For a certain period in the foot area, both swelling and soreness can be observed. That is why exercise therapy exercises, in general, should be gentle.

An integral part of rehabilitation is special shoes after surgery. Wearing Baruk shoes, which resemble platform sandals, for 4 weeks is a mandatory part of recovery. In the future, a person is recommended to wear individual orthopedic insoles. It is important to remember that after the operation, patients are forbidden to wear uncomfortable shoes, as they can provoke a recurrence of the disease. If we talk about returning to the usual rhythm of life, then it is possible in 1-2 months after the intervention. The duration of rehabilitation will depend entirely on the further load on the legs.

However, there are contraindications to the operation. It is better to refrain from corrective intervention: with immunodeficiency; if you have diabetes; with problems of blood clotting; in case of malignant tumors; in the presence of infectious diseases.

Alternative Treatments

Treatment with folk remedies for this pathology is a very common phenomenon. However, when looking for another folk recipe, it is important to understand that such therapy does not eliminate the problem, but only relieves unpleasant symptoms, for example, soreness and swelling. In addition, it must be remembered that any folk remedy must be previously agreed with the attending physician in order to avoid aggravating the condition.

Among the most popular remedies in the treatment of "bones" can be called medicinal herbs. As a rule, they resort to the help of dandelion, burdock and madder dye. A decoction is often prepared from the last herb (1 tsp per 1 cup of boiling water). To do this, a vessel with steamed grass is placed in a water bath. Then, after 10 minutes, the broth is filtered and allowed to cool. Use it 2 times a day for half a glass until the elimination of unpleasant symptoms.

If we talk about dandelion, then an external remedy is prepared from it. For this purpose, 100 g of pre-crushed dandelion flowers are taken and poured with iodine so that it covers the flowers. Next, the container with the product is removed in a dark place for 4 days. The resulting infusion is used in this way: the pre-steamed legs are wiped dry, and then with its help they “draw” a mesh on the bones.

In addition, burdock is considered an excellent remedy. Its large leaves are used, which are pre-lubricated with turpentine. These leaves are wrapped around the legs from the foot to the knee, after which they are wrapped with cling film and woolen cloth. When carrying out the procedure, care must be taken, as turpentine can cause burns. Such treatment sessions are carried out daily for 3 months.

Often, potatoes are also used in the treatment of bumps on the legs. However, this remedy is prepared not from raw tubers, but from their peels. To do this, fill a small saucepan 2/3 with cleanings, fill them with water and boil for 15 minutes. After that, a decoction just removed from the fire is poured into a bowl of water, then the legs are placed in for half an hour. Such procedures are carried out from 7 to 10 days. However, no matter what additional folk remedy a person decides to resort to, it is important to remember that you must first discuss it with a specialist.

Valgus splints for leg bone correction

Hallux valgus colloquially means a bump or bone on the big toe. Pathology occurs in 30% of the population, most often in females. It is not excluded the appearance of deformation in children.

Features of the development of the disease

Hallux valgus deformity occurs gradually, worsens with age, especially when wearing tight shoes. It is manifested by minor pains in the area of ​​​​the bumps, possible night cramps in the calf muscles.

The reason that hallux valgus occurs 10 times more often in women than in men is the weakness of the ligamentous apparatus, wearing high-heeled shoes. Hallux valgus pathology occurs in people of all age categories.

It is interesting!

Hallux valgus (ICB code 10 - 20.1) refers to diseases of the musculoskeletal system and connective tissues. Section XIII - "Acquired deformities of the fingers and toes."

The risk of developing the disease increases with age. At a young age, the deformity occurs in 3% of people, while in the elderly environment, the problem attacks every 5 people.

Causes of pathology

Hallux valgus disease is activated under the influence of various factors. These are congenital deformities of the foot, injuries, neurological diseases. The disease is provoked by a lack of connective tissue, when there are violations of the biomechanics of the first joint.

The finger is deformed against the background of developing flat feet, varicose veins, increased sensitivity of the joints, excessive load on the ligaments, which causes them to stretch.

An equally important cause of hallux valgus is a hereditary factor. In this case, it is important to intensively engage in prevention in order to avoid such a fate.

On a note!

Wearing uncomfortable shoes is an indirect factor in the appearance of bumps on the toe, but it can aggravate the development of the pathological process of hallux valgus of the foot.

Endocrine, hormonal disorders contribute to a decrease in the strength of the ligaments, as a result of which they cannot keep the joint in the correct shape. Accelerates the process of curvature of the joint.

Clinical picture

Hallux valgus develops for a long time, at the first stages the disease causes only cosmetic discomfort. Over the years, it becomes difficult to choose shoes, there are painful sensations when walking, the legs swell, and a bluish tint of the skin appears.

The main symptoms of deformity of the joint of the thumb:

• Protruding seal in the area of ​​the first toe;
• The thumb is displaced outwards;
• Puffiness, redness of tissues in the area of ​​deformation;
• The presence of callus, which appears at the site of compression of soft tissues;
• Pain as the pathology progresses.

In the later stages, an unbearable painful syndrome manifests itself, the shape of the foot gradually changes. Thumb movements are limited. If you take an x-ray, you can still detect subluxation of the first toe.

There are several degrees of hallux valgus of the foot, each of which has its own symptoms:

• Initial deformity - curvature of the finger by no more than 20 degrees, pain signs are not felt;
• Second degree - the joint is displaced up to 30 degrees, discomfort is mild;
• The third stage - the angle of curvature exceeds 30 degrees, pain becomes permanent;
• At the last stage, the deviation angle is more than 50 degrees, the disease manifests itself with severe symptoms, and surgical intervention is indispensable.

Only with a timely visit to the doctor, it is possible to cure hallux valgus by conservative methods, to completely get rid of the cosmetic defect in 6-10 months.

Attention!

In the photo, hallux valgus represents a severe deformity of the metatarsophalangeal joint of the big toe. The problem is a pronounced cosmetic defect, poses a danger to the functioning of the musculoskeletal system.

Diagnostic measures

To make a diagnosis, a visual examination of the foot is performed, an anamnesis is collected. The specialist is obliged to assess the severity of the change in gait, the degree of curvature of the joint, the presence of calluses and bone bumps.

The diagnosis is confirmed on x-ray in several projections, the picture allows you to determine the presence of subluxation of the first phalanx, divergence of the metatarsophalangeal bones, inflammatory foci.

The method of treatment depends on the angle of curvature, if the bone increases, then surgery is indispensable. MRI can be used as an additional diagnostic method when it is difficult to establish the type of deformity.

Conservative treatment

Treatment of hallux valgus without surgery is carried out using conservative methods, which include wearing special orthopedic shoes to regulate the load on damaged joints. To reduce pressure on the affected area, special insoles and pads are used.

During the period of intense pain syndrome, anti-inflammatory drugs are used:

• Kenalog;
• Diprospan;
• Hydrocortisone.

With the help of drug treatment, you can remove the disease symptoms, but it is impossible to get rid of the deformity. To relieve the inflammatory process, physiotherapeutic procedures are prescribed - magnetotherapy, paraffin applications, phonophoresis. It is possible to supplement the treatment of hallux valgus with warming ointments at the place of deformation.

Attention!

It is important to reconsider your lifestyle, balance your diet, add more calcium and phosphorus to your diet, stop wearing tight shoes, go swimming, and normalize your weight.

Splinting is an effective method of conservative treatment of hallux valgus, a special bandage can be adjusted independently, wear a corrector in turn if both legs are affected. Finger correctors are very convenient, which are worn only at night.

Folk methods of treatment

To alleviate the painful condition of hallux valgus, you can use non-traditional methods of treatment:

• Apply a piece of propolis to the sore spot, continue treatment until pain is eliminated;
• Mix 20 g of iodine and 10 g of crushed aspirin tablets, dilute with a little water or sage decoction, lubricate the damaged area before going to bed;
• Take a relaxing tonic bath with sea salt (2 tablespoons) and 10 drops of iodine. Dilute in a liter of water, hold the foot for 15 minutes, apply a nourishing cream;
• Steam your feet in a decoction of potato peelings - duration 20 minutes, you can add hot decoction as needed;
• Attach a peeled burdock leaf, pre-lubricated with turpentine, to the foot, wrap the foot with a warm scarf, remove the compress in the morning.

Thanks to such methods of treatment, it will only be possible to alleviate the patient's condition with hallux valgus deformity, and surgery will be required to completely eliminate the joint deformity.

Surgery

Surgical operations are divided into several types - performed on soft tissues, on bones and combined procedures. During Silver's operation, the tendon of the thumb muscle is cut off.

If the treatment of hallux valgus of the foot is carried out according to the McBright method, then the tendon moves. And when using surgery according to Shede, a bone growth is removed, partly a bag of the joint.

Another option for the operation is the displacement of the metatarsal bones in the right direction, after which they are fixed with special knitting needles. After three months, prompt removal of the built-in structure will be required.

With a strong curvature, a chevron osteotomy is used, when a bone wedge is cut below the head, followed by long-term rehabilitation therapy. The postoperative period lasts 6 weeks.

Attention!

An integral part of rehabilitation after surgical treatment is the wearing of special shoes - Baruk's shoes, which resemble platform sandals, in the future - the use of individual orthopedic insoles.

It is impossible to perform an operation with problems of blood clotting, immunodeficiency, the presence of infectious and inflammatory diseases, diabetes mellitus, malignant tumors.

To avoid the development of hallux valgus, it is important to monitor your weight, eat a balanced diet, drink enough fluids to normalize the salt balance. In order to strengthen the ligaments, regularly conduct a relaxing foot massage, thermal baths with the addition of a decoction of medicinal plants.

It is important to choose the right shoes - despite fashion trends, health should come first. It is useful to perform exercises using the toes - roll small objects on the floor, pick them up with your fingers, squeeze, roll from heel to toe.

Halus valgus is a serious disease that, if left untreated, can significantly impair the patient's quality of life by disrupting the functioning of the musculoskeletal system.

Take care of yourself and be healthy!

Foot injuries are becoming more and more common. One of the most common types of pathology of the joints of the foot is hallux valgus or Hallux Valgus.

What is hallux valgus?

Hallux valgus most often means a violation of the normal structure of the first metatarsophalangeal joint due to the displacement of the head of the first laterally (outward from the foot) and the inclination of the proximal phalanx of the first toe inwards.

This disease of the feet develops most often as a result of wearing tight, narrow shoes. As a result, under the influence of compression, a “forced” displacement of the proximal one occurs. In parallel with this, sprains and tendons of the finger develop, which further aggravates the situation. Another reason for the development of deformation is an innate predisposition to the development of this pathology.

As a result of external factors, the flattening of the arches of the foot occurs, after which it develops, which leads to the curvature of the big toe.

Most often, women are affected, regardless of age (usually the disease manifests itself in middle and late age).

Severity

Progressing, the curvature can be aggravated, which leads to even greater deformation of the finger. The severity is determined by changing the two main values ​​- the metatarsal-phalangeal and intermetatarsal (between 1 and 2 metatarsal bones) angles.

When the bones deviate by 12 and 25 degrees, respectively, the first degree of severity of hallux valgus develops.

If the process progresses, and the discrepancy is 18 degrees (metatarsal-phalangeal node) and more than 25 degrees between the bones of the metatarsus, the second degree of development of the disease is set in the diagnosis.

If the angles increase more than 18 and 35 degrees, respectively, you can set the third degree of severity of the disease.

Sometimes the question arises - what degree of severity should be set if a change in one angle is typical for, for example, the first degree, and the other angle is increased more than necessary. In such a situation, one should focus on changes in the metatarsophalangeal joint, since it is the change in it that is dominant in the pathogenesis of the disease.

Clinic

At the initial stage of the disease, the main manifestation of the disease will be stiffness when walking, a feeling of discomfort. With the progression of the process, the development of an inflammatory process in the joint bag (bursitis) is observed, which worsens the course of the disease. Add pain in the joint, aggravated by walking, the inability to implement the function of depreciation. As the disease progresses, the disease can be complicated by the development of osteochondrosis, osteoarthritis (due to flattening of the intervertebral discs). There are non-intense, aching pains in the spine, a feeling of heaviness and leakage after a period of rest, as well as intense soreness after physical exertion.

Along the way, edema develops in the joint: it increases in size, the articular folds are smoothed out. When the articular cartilage is depleted, the surfaces of the bones begin to rub against each other, which leads to the abrasion of the articular surfaces and the subsequent development of osteophytes.

Diagnostics

Usually, patient complaints, anamnesis, and visual examination are sufficient to make a diagnosis of hallux valgus. Plano-valgus is diagnosed using radiography of the affected joint in order to determine the angles of deviation between the bones and the severity. Sometimes magnetic resonance imaging and scintigraphy are used.

As additional methods used for differential diagnosis, a general blood test, a biochemical blood test,

diagnostic puncture of the joint, examination of the synovial fluid, followed by its inoculation on a nutrient medium (to determine microorganisms). The predominant indicators, which are the main diagnostic criteria, are the determination of rheumatic factor (diagnosis of rheumatoid arthritis), uric acid (gout), as well as some specific pathogens of arthritis.

Treatment of hallux valgus

Treatment for Hallux Valgus should begin with lifestyle changes. In the presence of excess weight, it is recommended to get rid of it (flat feet and osteochondrosis worsen the course of the disease and contribute to its progression). In this case, if Hallux Valgus does occur, treatment without surgery can have a significant effect.

Shoes that are believed to have caused deformity should be discontinued if possible.

It is important to give up bad habits.

As a preventive measure for the development of hallux valgus, comfortable shoes with soft soles without heels should be used. It will also be useful to carry out foot baths, as well as after a strong static load on the legs. Special orthopedic pads can be placed between the fingers to prevent displacement of the phalanx of the thumb.

If such conservative methods do not help, they resort to the additional use of symptomatic drug therapy aimed at improving the condition through a syndromic effect.

Medical therapy

In order to improve the condition for the treatment of Hallux Valgus, various medications are often taken.

The main groups of drugs are - preparations "Nimesulide", "Meloxicam". These drugs contribute to the relief of the inflammatory process by blocking cyclooxygenase-2, the main pro-inflammatory mediator. Drugs can relieve inflammation, reduce local swelling, reduce pain. They can be used both for oral use and through applications (lubrication) of the affected area.

In addition to NSAIDs, anti-inflammatory drugs used by electrophoresis are also widely used. This method allows you to bring the drug directly into the area of ​​​​inflammation, bypassing the gastrointestinal tract. Thus, the negative effect of NSAIDs on the gastric mucosa when taken orally is eliminated.

Surgery

With the ineffectiveness of conservative treatment resort to surgical intervention. It is carried out most often with the advanced course of the disease in its later stages, as well as with severe deformation of the fingers.

The sooner the operation is performed, the better the prognosis.

In the initial stages, a rather difficult operation was used to treat this pathology. Hallux valgus was eliminated by massive excision of the heads of the joint. Due to this, he was significantly injured, which led to remote dysfunction. Currently, priority is given to joint-preserving operations, the goal of which is minimal intervention on the bones with maximum impact on the tendons and ligaments. Operations of Chevron, Scarf (corrective osteotomies) are widely used. With their inefficiency resort to the creation of arthrodesis. Flat-valgus deformity of the feet in severe cases may require prosthetics of the affected joint.

Operations are carried out in six variations (although at present more than 130 of them have been created, but they have not confirmed their effectiveness).

In addition to the excision of the heads of the bones, the flattened arches of the feet are also corrected.

Prognosis after surgery

In the postoperative period, it is recommended to avoid significant physical exertion (they can contribute to improper joint recovery). You should not load your feet for one and a half to two months (the minimum period of joint fusion after surgery). For all this time, you should wear a special orthopedic boot. Under these conditions, the prognosis is the most favorable.

If the condition was diagnosed out of time and the process progressed and led to irreversible changes, then the prognosis smoothly passes into the group of conditionally unfavorable. This disease of the feet contributes to the growth of disability, impaired walking. In this case, even the intervention of surgeons becomes ineffective, since it only slows down the progression of the process, but does not eliminate its cause.

Should this condition be treated?

This question is often asked by many people. For some, the development of such a deformation is a disaster, since this group of people sacredly protects their appearance and cannot allow an unpleasant defect to spoil their appearance. Others are calm about changing bones and are in no hurry to run to see a doctor. How to be - to treat or not to treat? Should I turn to surgeons for help with the development of Hallux Valgus? Reviews about this disease are varied and specific.

On the one hand, it is best to contact an orthopedist or traumatologist in a timely manner with the slightest changes in the joint. Timely diagnosis of this disease allows you to get rid of it without any undesirable consequences. The later this condition is detected, the more severe the consequences for the musculoskeletal system it can turn into. That is why the question of the treatment of valgus deformity of the thumb is purely individual. Everyone decides for himself whether it is worth “going under the knife”, or it is better to leave everything as it is.

Valgus deformity of the foot is one of the most common orthopedic pathologies today, which manifests itself in the deviation of the big toe inside the foot.

In addition to an ugly appearance, such a deformation violates all the structures of the foot: tendons, ligaments, bones and joints. In addition to the curvature of the toe and the formation of a protruding bone on the inside of the foot, other orthopedic diseases may also appear, which include:

• deforming arthrosis of the metatarsophalangeal joints;
• chronic bursitis;
• transverse or combined flat feet;
• ecstosis of metatarsal heads;
• internal (varus) deviations of the first metatarsal bone.

The reasons

There can be several factors that provoke the occurrence of bones on the legs. This includes a genetic predisposition to the disease, and the presence of inflammatory processes in the ligaments and joints.

Also, complications in the form of bulging bumps on the feet can occur due to foot problems such as clubfoot and flat feet.

Most of all, female patients are affected by this pathology; in them, valgus deformity of the feet is the most common orthopedic pathology after the age of thirty.

Perhaps the most common cause of hallux valgus in young women is the constant wearing of beautiful, but very uncomfortable, too narrow shoes, as well as shoes with high heels.

This also includes wearing shoes that are too short (smaller than their size), in which the toes are constantly in a forced unnatural position, which contributes to the appearance of bursitis of the big toe (and it, in turn, can provoke hallux valgus deformity of the foot).

The constant curvature of the foot in one place and leads to the appearance of bumps. Over time, these protruding bones begin to cause discomfort and very painful sensations.

Valgus deformity of the foot is also based on congenital weakness of the bone and connective tissues, which leads to the appearance of flat feet (this is especially true for women, since their connective tissue is naturally rather weak and tends to be quickly affected in the presence of adverse factors).

It is necessary to emphasize once again that the deformities of the foot, first of all, are caused by incorrectly chosen shoes. Shoes with high heels or with a narrow toe lead to an uneven distribution of the load on the forefoot, which gradually develops deformation of this zone, arthrosis of the big toe joint appears.

Based on this, the best way out of this situation is to prevent the occurrence of such a problem. If suddenly you notice that the bump has already begun to grow and there is a deformity of the foot, you need to urgently consult a doctor for medical help.

You can summarize this section and highlight the following main reasons for the development of hallux valgus deformity of the foot:

• Flat feet - in almost all patients suffering from this pathology, transverse flat feet are also detected. Most of them are also diagnosed with longitudinal flat feet.
• Osteoporosis - Osteoporosis is a loss of calcium from the bones plus a change in their structure. All this provokes deformation of the foot and bones.
• Excess body weight - in case of excess weight, there is an increase in the load on the feet and the development of flat feet, and as a result of this, hallux valgus deformity of the foot appears.
• Hereditary predisposition to the disease - a weak muscular-ligamentous apparatus can be from birth. In this case, the likelihood of flat feet is very high, which, in turn, is the cause of hallux valgus deformity of the foot.
• Wearing improperly selected shoes (this was discussed in more detail at the beginning of the paragraph on the causes of the disease).
• Violations of the endocrine system of the body - due to sudden changes in the hormonal background, for example, during pregnancy and menopause, or even just small but constant fluctuations that are caused by the menstrual cycle - all this can cause weakening of the ligamentous apparatus, which, as is already known , and leads to flat feet and foot deformities.
• Also, various injuries to the feet can be attributed to the causes of the development of pathology.

Disease classification

In medicine, the following types of valgus deformity of the feet are distinguished:

• static;
• congenital;
• rickets;
• as a result of clubfoot treatment (hypercorrection);
• traumatic;
• paralytic.

According to the severity, the following stages of the disease are distinguished:

• easy stage;
• severe stage;
• middle stage.

In addition, there are three stages of valgus deformity of the first toe, depending on the angle of deviation of the big toe:

• Stage 1 - the thumb deviates at an angle of less than 20 degrees;
• Stage 2 - the thumb deviates at an angle of 25 to 35 degrees;
• Stage 3 - the thumb deviates at an angle of more than 35 degrees.

Symptoms and signs

To identify this orthopedic pathology in the initial stages, it is important to know what the primary manifestations of the disease are. Typical manifestations of foot deformity symptoms depend on its stage.

1. At the first (initial) stage of the disease, the following manifestations can be distinguished:

• The very first and main symptom of the disease is uncomfortable and painful sensations while walking, fatigue, difficulty wearing shoes, after which painful corns and calluses begin to appear. Over time, there is a change in the shape and position of the joints of the big, as well as the second toes of the foot, a “bone” grows, the skin in the area of ​​​​the bone becomes red, there is a slight swelling in this area.
• The presence of this disease can also be indicated by painful sensations of a aching nature in the phalanges, which are exacerbated by movement.
• The skin at the site of the protruding bone acquires a characteristic abrasion.

2. At the middle stage of hallux valgus:

• It can be noted the appearance of an inflammatory process in the joints.
• Typical are pain and swelling in the affected area, the appearance of growths in the area of ​​the first head of the metatarsal bone.
• The appearance of corns under the third and middle phalanges of the finger is characteristic.

3. In the advanced stage of pathology:

• You can see with the naked eye a strongly protruding thorn-growth.
• The skin under the second and third lower phalanges is covered with calluses and keratinized skin.
• This stage is characterized by very strong painful sensations in the big toe, as well as on the soles of the feet.

Diagnosis of valgus deformity of the foot

The very first step in establishing the diagnosis of hallux valgus deformity is a visual examination by a doctor and setting the stage of the disease.

During the examination, the state of the vascular status, turgor (elasticity) of the upper area of ​​the foot, as well as the plantar surfaces are taken into account, the comparative tactile sensitivity of the legs and the functionality of the main phalanx with the first metatarsophalangeal joint are determined.

The doctor should consider any possible involuntary restrictions on the movement of the foot in order to determine the exact cause of the deformity. Due to the distance between the metatarsal heads, the degree of damage to the toe can be determined.

The complaints of patients that will indicate valgus deformity include: stiffness in movements, aching pain in the front of the leg, a feeling of heaviness after strong physical exertion.

There are also a number of additional diagnostic methods, namely:

1. After a mandatory examination, in order to determine detailed changes in the bone tissue, the patient is sent for radiography (an x-ray of the foot is taken in three projections).
2. Carrying out plantography (analysis of a picture of the foot) - helps to establish the degree of possible flat feet as accurately as possible, and the level of load on the feet is also examined.
3. The method of computer analysis - podometry, helps to determine the pressure on the feet.

According to the results obtained from such a comprehensive diagnosis, appropriate methods for the treatment of hallux valgus deformity are selected.

Treatment

Since manifestations similar to signs of hallux valgus are also observed in other orthopedic pathologies, first of all, you need to contact a competent specialist who can establish an accurate diagnosis. If this particular disease is diagnosed, treatment can begin. You should be prepared for the fact that it will be protracted and rather laborious.

Treatment of valgus deformity of the foot is divided into two types: conservative and surgical. The first type is used in the initial forms of pathology and, unfortunately, does not lead to a complete correction in all cases. Despite this, due to the correct and timely approach, it is possible to significantly slow down the further progress of the deformity and temporarily delay the surgical intervention.

Let us consider in more detail the methods of conservative treatment. This may include:

• the use of special orthopedic shoes, night splints and arch supports, as well as interdigital pads and insoles, orthopedic correctors (the use of these devices helps to correct the gait, eliminate pain and slightly slow down the development of this pathological process);
• carrying out physiotherapy procedures;
• drug therapy, which consists in the introduction of hormonal agents into the joint cavity (for example, such as diprospan or hydrocortisone). Hormonal drugs eliminate the inflammatory process.

Drug treatment also includes the appointment of corticosteroids and the use of anti-inflammatory drugs in conjunction with them. For the best effect, physiotherapeutic manipulations are also added here at the same time. In a situation where valgus is a consequence of any systemic disease, first of all, the causes that provoked the underlying pathology, which led to valgus deformity of the foot, are identified and treated.

In the process of treatment, orthopedic shoes individually selected for each patient play a very important role. It should have sufficient softness, be sure to have a wide toe, a heel of no more than 4 centimeters is allowed. In the early to moderate stages of hallux valgus, treatment should begin with advice on choosing the right shoes—shoes that are snug and loose, with a wide toe that will reduce pressure and discomfort, and help prevent further deformities.

Often, hallux valgus deformity of the 1st toe is accompanied by flat-valgus deformity - flat feet. With flat feet, there is a change in the direction of the axis of the foot and a decrease in its arches. In this case, the shoes should have a high and hard back, as well as a tight arch support. It is extremely important to use special orthopedic insoles, the best option is when they are made according to a personal order, then even the slightest features of the patient's own foot can be taken into account.

If we talk about physiotherapeutic procedures, shock wave therapy brings a very good effect here. Thanks to its therapeutic effect, blood circulation in the affected area improves, as well as pain and swelling decrease.

Surgical intervention, in most cases, is resorted to already at the advanced stages of the disease. Although the operation can be performed at the beginning of the hallux valgus deformity, in this case, the surgical intervention will simultaneously be the prevention of arthrosis in the first metatarsophalangeal joint. Modern surgical techniques do not destroy the joint, retain its support and mobility.

To date, more than 150 different methods of surgical correction of the appeared valgus deformity of the foot are known. The common goal of these methods is to reduce the angle between the metatarsal bones, which allows the big toe to be placed in the correct position.

There are such methods of surgical intervention:

• reconstruction of deformed bones;
• removal of the growth in an operative way;
• an operation by which the periarticular muscles are balanced;
• carrying out distal and proximal osteotomy, which consists in changing the angle between the bones;
• arthrodesis - surgical intervention to fix the joint;
• tendon transplant;
• joint implantation;
• as well as about 93 more methods that are selected individually for each patient.

The rehabilitation process after surgery can last from one to two months, therefore, for 1.5 months, doctors advise wearing a special orthopedic boot that will help to securely fix the diseased limb and provide it with maximum peace during movement.

In addition to the methods of treatment described above, in the early stages of the disease, a fairly good result is brought by the systematic implementation of special exercises. Exercises develop toes, strengthen weakened muscles. The most important thing is that they are performed daily and without gaps.

In addition to therapeutic exercises, you also need to do a general strengthening massage every day, but not only on the feet, but also on the buttocks, thighs, back and internal muscles of the lower leg.

Which doctor treats valgus deformity of the foot