Hallux valgus: degrees and treatment of the big toe. Halus valgus: causes, symptoms, stages, treatment and rehabilitation

The deformity of the first toe is a common pathology among women of middle or older age. She is not given importance for a long time, starting to the point that she reduces the quality of life, although with Hallux Valgus treatment without surgery is quite possible.

Symptoms of pathology range from discomfort when walking and the formation of a small protrusion at the base of the thumb to a significant deformity that causes gait disturbance and constant pain.

The reasons for the development of pathology are associated with weakness of the musculoskeletal apparatus, which, against the background of concomitant factors, leads to a pathological deviation of the thumb. To diagnose the disease, an external examination is sufficient, and the exact causes of the pathology are found out using additional methods. The degree of hallux valgus is distinguished by the angle of deviation of the finger.

Description

Hallux Valgus (in Russian transcription Hallus Valgus) is a widespread orthopedic pathology. Valgus deformity of the foot affects both sexes, but women are 10 times more than men. As a result of a change in the relative position of the bones, deformation of the foot is observed, calluses, corns are formed, unpleasant sensations appear when walking, and difficulties in choosing shoes. The peak incidence occurs in women over 35 years of age, there is a hereditary predisposition.

Foot deformity develops due to the extensibility of muscles and ligaments, for which there may be several reasons:

• Hereditary weakness (dysplasia) of the connective tissue;
• Consequences of injuries, certain diseases (for example, rickets, poliomyelitis);
• Lack of adequate physical activity, obesity;
• Excessive physical activity;
• involutive processes;
• Congenital anomalies of development.

When wearing uncomfortable shoes (tight toe, high heels) or staying in an upright position for a long time, the load on the joint between the I metatarsal bone and the main phalanx of the finger changes. The absence of special physical activity, hereditary predisposition or the consequences of diseases lead to a decrease in muscle tone, ligament extensibility, capsular apparatus, aponeurosis. As a result, a fan-shaped divergence of the bones of the metatarsus and a pathological reversal of the first metatarsal bone are formed. This causes instability of the joints, so the bone is gradually displaced inwards. The transverse arch flattens, the foot expands, the thumb turns outward.

The constant friction of the inner surface of the extended foot against the shoes leads to the appearance of corns, and in the long term - to the growth of cartilage and bone tissue with the formation of exostosis (a characteristic "bump"). A change in the distribution of the load on the parts of the foot leads to pressure overload of the II and III metatarsal bones, which is initially manifested by pain and the appearance of corns, and then by the development of arthrosis. The displacement of the thumb affects all other fingers, causing them to deviate outwards or form a malleus deformity of the second finger.

At the initial stages of deformation, aching pain is noted, which increases in the evening. During the night, the pain disappears, at this time, with Hallux valgus, the bandage works especially effectively. The deformity of the foot is not pronounced. The friction of the inside of the foot against the walls of the shoe is manifested by redness and minor skin injuries. Irritation of the periarticular tissues leads to frequent exacerbations of bursitis.

Further deviation of the toe and metatarsal bone causes prolonged intense pain after a short walk. It is possible to pinch the nerves, which is manifested by a sharp burning pain. Significant deformity of the foot. The pressure of the shoes causes the formation of calluses, the skin becomes rough, and the bursitis becomes chronic. Perhaps traumatic growth of exostosis, subluxation of the I metatarsophalangeal joint. Calluses appear on the sole - evidence of a redistribution of the load on the foot.

Severe deformity of the foot makes it difficult to wear shoes. The pain becomes constant, gait is disturbed. The skin in the places of contact with the shoes is rough, exostosis is pronounced. In the projection of the metatarsophalangeal joint, redness and swelling of the skin are revealed, sometimes ulcers, suppurations appear, up to the development of osteomyelitis. There are sharp pains on the sole due to compression of the plantar nerve by the III metatarsal bone. Movement in the metatarsophalangeal joint is difficult.

With Hallux valgus, the severity of the deformity is determined by two angles: between the I and II bones of the metatarsus and between the metatarsal bone and the main phalanx of the thumb. According to the first, the magnitude of the deviation of the metatarsal bone becomes clear, according to the second, the magnitude of the deviation of the finger. The angles are calculated from the X-ray data. There are such degrees:

• Grade I: intermetatarsal angle 5-20º, metatarsophalangeal angle 10-40º;
• Grade II: intermetatarsal angle 20-30º, metatarsophalangeal angle 40-70º;
• Grade III: intermetatarsal angle >30º, metatarsophalangeal angle >70º.

Each degree is characterized by different clinical manifestations. At the first degree, tissue changes are minimal, conservative treatment started on time is most effective. At the second degree, manifestations of moderate severity are observed. The third degree is a severe variant of hallux valgus.

Diagnosis of the disease

Already at the initial examination, even a generalist can make a diagnosis. The foot is flattened, there is a deformity of the big toe, exostosis is located on the inner surface of the foot, areas of rough skin are observed. Palpation of the metatarsophalangeal joint is usually slightly painful. Movement is preserved, but somewhat limited.

To determine the tactics of treatment, it is necessary to consult an orthopedist, a traumatologist, and if the nerves of the foot are involved in the process, a neuropathologist. The doctor finds out the presence of predisposing factors, prescribes radiography to calculate the angles between the bones, ascertain the degree of their changes. The radiograph reveals:

• exostosis;
• fan-shaped divergence of the metatarsal bones;
• subluxation / dislocation of the thumb;
• deviation of the first metatarsal bone inside;
• abnormal location of sesamoid bones;
• arthrosis of the metatarsophalangeal joints.

For additional diagnostics, CT / MRI may be prescribed.

Surgery for Hallux Valgus

About 300 surgical methods for the treatment of this pathology are known. With Hallux Valgus, surgery can be performed at any stage of the disease in the orthopedic / trauma department. If the general condition of the patient is very severe, then a corrector is used for Hallux valgus, and surgical treatment is not used. Depending on the severity of the deformity, they operate:

• only soft tissues;
• only bone structures;
• bones and soft tissues.

At the I degree, interventions on soft tissues will be effective in order to restore the traction of the muscles of the foot. Operations are performed by Silver (cutting off the tendon of the adductor muscle), McBride (moving the tendon of the adductor muscle), Shede (one of the above options in combination with exostectomy and removal of tissues of the periarticular bag).

At II and III degrees, operations on the bones or combined interventions on soft tissues and bones are performed. A chevron osteotomy is performed (removal of a V-shaped section of the bone with restoration of the axis) or Scarf osteotomy (bone cut into several sections with their reposition and subsequent fastening with metal screws). In case of very severe damage to the joint, arthrodesis (creation of ankylosis) or the installation of an artificial prosthesis is indicated.

After the operation, a long (several weeks) wearing of a special orthosis or a plaster cast is required, it is not recommended to load the leg, the body weight should be transferred to the heel. During rest, the leg should be given an elevated position. After removal of the cast/orthosis, the patient should wear custom-designed orthopedic shoes, use liners/insoles to form the arch of the foot and prevent re-deformity. The operated foot should be loaded gradually, exercise therapy, and physiotherapy should be carried out.

Treatment for Hallux valgus should mainly be aimed at eliminating the pathological load. Doctors advise to avoid wearing tight shoes, high heels, avoid long walks and standing on your feet, lose weight. All conservative methods are very effective in the early stages of the disease. With severe deformities, they provide preparation for surgery or alleviate the condition of those for whom surgical treatment is not indicated.

To relax overworked muscles in the evening, baths with warm water and essential oils (for example, lavender oil) are recommended. It will also be effective in the fight against corns and calluses. During the day, therapeutic exercises are shown to strengthen muscles: moving small objects (sticks, pencils) with the foot, walking on uneven surfaces (sand, pebbles), rolling the ball, practicing on the Swedish wall, picking up a piece of fabric into folds and others.

To tone the muscular-ligamentous apparatus and reduce inflammation, ultrasound treatment (ultraphonophoresis of medicinal substances), electric (UHF therapy) and magnetic fields (inductothermy, magneto-laser therapy, local magnetotherapy), heat therapy (paraffin therapy, ozokerite therapy), electrophoresis, as well as professional massage and foot massage. Special orthopedic devices that should be bought for Hallux valgus are liners, insoles, interdigital bolsters, ties, correctors, bandages, orthopedic shoes. They help to fix the physiological position of bone structures and soft tissues, reduce the degree of deformation even in severe cases. For maximum effect, it is important to use them around the clock.

In inflammatory processes (bursitis, arthritis) or severe pain, local anti-inflammatory ointments and gels (based on diclofenac, ibuprofen, nimesulide) should be used. Arthrosis changes are treated with chondroprotectors and physiotherapy. Bacterial complications may prompt the administration of topical antiseptics/antibiotics. Nerve pathology should be treated in conjunction with a neurologist.

Elimination of Hallux Valgus with a night bandage (valgus splint)

The use of orthopedic splints is indicated for the conservative treatment of hallux valgus or for postoperative recovery. They gradually correct the position of the finger, thereby eliminating pain and discomfort. The night bandage is not designed to be worn while walking, it is used either during sleep or at rest (when the patient is sitting or lying down). It is worth starting use from a few hours, gradually leading up to the whole night.

In the treatment of Hallux valgus, reviews indicate that the rigid construction of the splint provides better fixation of the tissues; it does not interfere at all during sleep. The only contraindication for the use of any type of orthopedic correctors is damage or infection of the skin of the foot.

Take care of your legs and do not bring the case to surgery. Rather, buy a valgus splint and apply it every night. The results will not be long in coming. Be healthy!

Halus valgus is one of the most common orthopedic diseases. Not a single person is immune from the appearance of an ailment. However, according to statistics, women are more susceptible to the onset of the disease. The risk of bunion formation in the legs increases with age. Valgus deformity of the big toe is diagnosed in 3% of young people. More than 30% of elderly people are familiar with the curvature of the bone of the first toe.

The disease is based on a serious deviation in the structure of the foot. The development of the disease is very slow. The initial stages of the disease are difficult to identify. That is why pathology is diagnosed after complications have begun to develop. Her therapy should be timely. At the initial stages, massage, gymnastics, means for correction (fixators, tires) contribute to correcting the situation.

Conservative therapies are effective, but only in the initial stages. With a strong protrusion of the bone, intense pain, as well as the ineffectiveness of conservative methods, special exercises and wearing overlays will not help. An operation is scheduled (open, minimally invasive or percutaneous). The cost of surgery, as well as the duration of the recovery period, vary depending on the type of surgical intervention.

It is important to understand that valgus deformity of the big toe is not only a cosmetic defect, it is a serious disease that requires immediate treatment. Only an orthopedist can treat the disease and prescribe the use of medications, fixatives and other means. Asking for advice on the forums or blindly trusting reviews on a particular remedy for bones on the legs is at least unreasonable.

The disease brings a lot of inconvenience to a person's life. Because of the crooked toe, it is difficult to choose shoes, the growth has a rather unaesthetic appearance, and besides, when rubbing, it is often accompanied by bleeding. Often, bursitis develops against the background of this disease. Along with the progression of the disease, discomfort and intense pain in the lower extremities and the curvature of the remaining fingers are noted. Any movement is accompanied by unbearable pain.

Because of the disturbed gait, soreness in the lower leg appears. Ligaments, bones and joints of the foot are closely connected. Therefore, any deformation of one part is accompanied by other changes in the other. The deviation of the thumb is visible to the naked eye. But few people know about the hidden changes that can be seen on x-rays. On the pictures you can see the angle of deviation of the first metatarsal bone inward, displaced sesamoid bones. The curvature of the bone entails a violation of the arch of the foot. There is a change in shape, a violation of the shock-absorbing function.

The development of valgus deformity of the big toe is provoked as a rule:

• constant wearing of uncomfortable shoes;
• injuries;
• the presence of gout;
• being overweight or obese;
• genetic predisposition;
• pregnancy
• flat feet;
• diabetes mellitus;
• endocrine ailments;
• the presence of osteoporosis.

Valgus deformity of the thumb: stages of pathology, as well as what kind of diagnosis is carried out

Metatarsal deviation is a fairly common ailment that can develop in both a child and an adult. Symptoms of the disease depend on the degree.

Valgus deformity of the thumb (ICD-10 code - M20.1), regardless of the cause (transverse flat feet, articular pathologies, wearing uncomfortable shoes, bursitis), is accompanied by the following manifestations:

• the appearance of a soft formation on the first toe;
• hyperemia of the affected area;
• intense pain;
• change in the shape of the finger;
• the formation of a hard bump;
• the formation of callus, irritating the skin;
• loss of mobility of the affected finger;
• an increase in the size of the joint;
• bulging to the side;
• twisting the finger inward;
• damage to the metatarsophalangeal joints;
• fast fatigability of the legs.

Bones on the legs are a real problem, as a person with the progression of the disease hurts not only to walk, but also to just stand. Moreover, discomfort and unpleasant symptoms appear at rest. There are several degrees of valgus deformity of the thumb.

The first degree of progression of the pathology is accompanied by a displacement of the bone by 20 degrees. At this stage, there are no complaints of discomfort or pain.

The second degree is accompanied by a deviation of the bone by 30 degrees. The appearance of non-intense painful sensations is noted. As for the third degree, at this stage the joint deviates by 40-50 degrees and is characterized by intense pain.

As for the fourth degree, it is accompanied by a deviation of the finger by 50 degrees or more. The pain manifests itself not only at the moment of movement, but also in the supine or sitting position. It is difficult for a person to choose shoes.

In addition, the formation of corns is noted. In order to establish an accurate diagnosis, the doctor will study the history, conduct an examination and prescribe the necessary studies. Without fail, during the examination, the person’s gait, the position of the first toe and the range of his movements are assessed.

In addition, the following is scheduled:

• Radiography. This diagnostic method helps to identify characteristic abnormalities of the phalangeal joints, pathological bone growths, as well as bone deformities.
• Computer plantography. This method helps to identify the degree of hallux valgus deformity of the first toe.
• Computer podometry. Allows you to identify the initial degree of the disease based on changes in gait.
• Biochemical research.

After the examination, the doctor will select the therapy. With the initial symptoms of the disease, home therapy is possible. The use of orthopedic insoles, gymnastics and massage are prescribed.

Equally important is the refusal to wear high-heeled shoes. Both a man and a woman with protruding bones need to wear high-quality comfortable shoes, leather with a dense sole. Valgus deformity of the first toe of the first stage is cured quickly. The main thing is to follow all the recommendations of a specialist.

Valgus of the big toe: complications and prevention

Comprehensive conservative treatment helps in improving blood circulation, strengthening muscles and ligaments, and also helps to minimize discomfort, soreness and fatigue. Therapy of the disease begins with the selection of comfortable shoes. Properly chosen shoes will not cause stress, pain and friction while walking, and will also help prevent further progression of the pathology.

In order to minimize pressure, special clamps are used. For the treatment of valgus deformity of the big toe, the use of drugs with anti-inflammatory and analgesic effects is prescribed: Kenalog, Diprospan, Hydrocortisone. Physical therapy helps to minimize inflammation and soreness. Often, the use of ultrasound and diathermy, ozokerite-paraffin applications, and phonophoresis are prescribed.

Massage with valgus of the big toe helps in eliminating pain, normalizing blood circulation. Often a course of massage is carried out - 10 sessions. The course is recommended to take place every two months. Treatment of valgus deformity of the big toe involves the use of gymnastics, which contributes to a significant correction of the curvature of the bone. It is helpful to tiptoe, walk on the outside of your feet, walk on uneven surfaces, and pick up small objects from the floor with your toes.

Various orthopedic products are widely used for the treatment of bone curvature. Pads, rubber cuffs with special rollers that help protect the middle metatarsal bones from pressure, interdigital pads to prevent ingrown nails - all this is very effective in this pathology. With a critical curvature of the foot, orthopedic shoes are made with the laying of the arches of the foot, which contributes to the unloading of the foot.

It is important to understand that inappropriate treatment of pathology, as well as its absence, is fraught with the development of deforming arthrosis of the joints, as well as restructuring of the structure of the metatarsal bones. With a clearly progressive nature of the disease, as well as the ineffectiveness of conservative methods - the use of physiotherapy procedures, wearing special shoes and the use of fixators, the use of massage and gymnastics, a surgical intervention is prescribed.

Thanks to modern medical orthopedic equipment, today there is the possibility of low-traumatic correction of the joint. An operation is performed, after which there is no need to apply plaster or mount additional structures. During surgery, the angle between the bones of the foot is corrected. Surgical treatment of valgus deformity of the big toe is one of the most effective methods of therapy.

In order for the recovery period to be successful and complications not develop, patients are recommended:

• use of crutches;
• undergoing a course of physiotherapy;
• the use of a special bandage or wearing shoes with wooden soles;
• use of orthopedic correctors.

Any operation is associated with the risk of complications. An operation for such an ailment as valgus of the big toe is fraught with: penetration of infection into soft tissues, the occurrence of osteomyelitis or arthritis, slow fusion of bone tissue, numbness of the dermis. Prevention of the disease consists, first of all, in wearing the right moderately free shoes, with a heel not exceeding 5 cm.

High heels not only provoke the development of flat feet, but also the formation of bumps, as well as an increase in the load on the spinal column, muscles of the thighs, lower leg and Achilles tendon. In order to prevent the development of the disease, the use of orthopedic insoles is recommended. It is important to regularly undergo examinations by an orthopedist and observe the regime of work and rest (if work is related to being on your feet).

What is hallux valgus

- a Latin term used in the presence of a pathological deviation of the first toe outwards. This deformity of the forefoot - hallux valgus is quite common among women, but can also occur in men.

There are many reasons for the development of this deformation. The most common hereditary nature of the disease. The basis of the valgus deviation of the first toe is the development of longitudinal-transverse flat feet, i.e. flattening of the longitudinal and transverse arches of the foot, which sharply disrupts the biomechanical relationships in the joints of the entire foot when walking and starts a chain of pathological processes, which in turn leads, at the beginning, to the development of compensatory processes, then to decompensation.

The development of forefoot deformity is facilitated by the so-called predisposing factors, which most often include:

• overweight,
• wearing narrow shoes with high heels,
• long static loads on the feet, etc.

Hallux Valgus degrees

There are several degrees of Hallux valgus. The degree of hallux valgus is determined by changing the angle between the first toe and the first metatarsal bone - Hallux valgus angle. important the value for determining the degree of Hallux valgus is the so-called intertarsal angle(Intermetatarsal angle), - the angle between the first and second metatarsal bones. Depending on the magnitude of these angles, they are distinguished. 3 degrees of valgus deviation of the first finger - Hallux valgus

The presented table shows the values ​​of the angles and the degree of valgus deformity of the first finger corresponding to it:

Each the degree of Hallux Valgus has its own clinical manifestations. Hallux valgus is the main symptom of hallux valgus. Patients are also concerned about pain in the area of ​​the first metatarsophalangeal joint, where they note an increasing bone, swelling of the joint, redness of the skin in the area of ​​this joint. In the future, the so-called transversely spread foot is formed, which is not able to perform the function of a body weight shock absorber. Thus, a persistent pathological deformity of the forefoot develops.
The tactics and approaches to the treatment of Hallux Valgus certainly depend on the degree of deformation and clinical manifestations.

Treatment of hallux valgus

Video - surgery for Hallux Valgus, 1:49 min, 3 Mb.

In most cases, in the early stages of the disease, The first treatment option for Hallux Valgus is conservative treatment. which includes:

• lifestyle correction (weight loss, sports, etc.)
• the use of orthopedic shoes to eliminate interaction in the area of ​​the first metatarsophalangeal joint - in the area of ​​\u200b\u200bthe "painful bump",
• use of interdigital pads
• using orthopedic orthoses for the first toe.
• the use of insoles corrective arches of the foot.

Among the drug treatment, drugs from the group of non-steroidal anti-inflammatory drugs, physiotherapy procedures are often used.
With the ineffectiveness of several courses of conservative treatment or with advanced stages of the disease, surgical treatment of hallux valgus deviation is used.

The operation for Hallux Valgus is carried out free of charge as part of the VMP

In case of medical indications and the availability of quotas in the referral, operations are performed in our center at the expense of funds allocated under the program for the provision of high-tech medical care (HMP)

Surgery for Hallux Valgus

Currently, a huge number of different methods of surgical treatment of Hallux Valgus are known, which indicates an unresolved problem and the absence of a universal method for treating this deformity. The most widely used methods are associated with the implementation of various osteotomies of the metatarsal bone and the main phalanx of the first toe. These techniques often make it possible to achieve the desired correction of the deformity in Hallux Valgus, and to leave the patient's hospital bed in a short time after the operation. In most cases, when using modern methods of treatment, patients do not use plaster immobilization of the feet and there is no need to use additional support - crutches.

Patient Irina, 47 years old. Photos of feet before and after Hallux Valgus treatment

Patient Olga, 62 years old. Photos of feet before and after Hallux Valgus treatment

Video reviews about the treatment of toe deformity in our center

Patient Saurina E.L. - surgery for hallux valgus

Patient Burkova E.D. - surgery for hallux valgus

Patient Shestakova S. - surgery for bunions on the legs

Zdorina T.V. 45 years old - removal of bones on the legs

Video about the treatment of Hallux Valgus

Pavel Zhadan about the treatment of Hallux Valgus on the TVC channel

On April 18, 2013, the TVC channel aired the program “Doctor I”, in which the traumatologist-orthopedist P.L. Zhadan took part. The program touched upon the topic of the treatment of flat feet and one of the most common orthopedic pathologies of the forefoot - hallux valgus (hallux valgus). The program covered the causes of static deformities of the feet, prevention and modern methods of treating patients with this orthopedic pathology. We recommend watching the full version of the program on our website.

It might be interesting

User questions about Hallux Valgus

Is conservative treatment of flat valgus deformity possible at the age of twenty? If so, what exercise should be used? How long does the treatment take?

Doctor's answer:
At this age, conservative treatment of such a pathology is possible, it all depends on the degree of deformation. You need to come in for a face-to-face consultation.

Severe pain in the knee joint, radiating to the feet. Both feet were operated on, osteosynthesis due to halgus valgus 3 years ago. Available

swelling and crunching, severe pain during the day. She was also diagnosed with lumbar osteochondrosis and cervical spondyloarthrosis. Pain in the left leg, also radiates to the lower back. Which doctor should I contact for a correct diagnosis. I'm 32 years. Thank you.

Doctor's answer:
Address to the neurologist.

On October 10, I had an operation for p-halyus valgus in another clinic. I understand that the minimum -rehabilitation period is 3.5-

month. But problems have been outlined, which, ideally, should not be. On one leg, it looks like Morton's neuroma (2-3 fingers), on the other (in the presence of initially lymphostasis in the zone of 1-3 fingers), the second and third fingers bend down and when put on shoes "weakly wrap themselves in a ring." Taping attempts, injections with d-iprospan did not help. I am 62 years old, there are certainly age-related problems with arthrosis, but I would like to correct what I have listed. Is it possible for you to consult on such issues and see if you have real solutions for such problems? Sincerely, - Vera Ivanovna-

Doctor's answer:
Yes, a consultation is possible in our hospital. Call the phone numbers listed on the site.

I have bilateral longitudinal flat feet 3 tbsp. , plano-valgus deformity of both feet, calcaneal spurs on both sides, doa of the joints of the feet stage 2.

Do you have surgery? Will they raise the arch of the foot? I don’t have the strength to walk, but I still have to work. Is it possible with a quota? Please call back, because I do not know how to use mail 89922049665.

Doctor's answer:
In our center of traumatology and orthopedics, operations on the feet are performed. You need to call the phone numbers on the site and make an appointment.

Are operations to eliminate flat-valgus deformity of the feet performed on children (7 years old) or are they shown only exercise therapy, massage and physiotherapy?

Doctor's answer:
Our clinic treats adult patients.

The operation of hallux valgus is half the battle. After her, the second important stage is rehabilitation. Feedback on how things went is valuable information. The advice of those who are already behind is very important for those who are going to take a step towards an easy walk and return to beautiful shoes. After all, almost every person who loves himself strives for this. But the pathology that interferes with putting on a chic model is a lump of hallux valgus, popularly called the “bone” of the big toe, has a chronic, progressive character. Today we will talk about the advanced stage of this disease, what can be the solution to the problem, we will find out what role rehabilitation has. Let's get acquainted with the complex of exercises.

The main essence of the formation of hallux valgus is the development of deformation of the metatarsophalangeal joint, it leads to the deviation of the big toe on the foot. Due to cosmetic defects and problems with complications, hallux valgus surgery is often recommended, rehabilitation, sometimes lasting up to half a year.

Stages of surgical intervention

Of course, there are also conservative methods - wearing special fixatives, massage and physiotherapy. However, these methods are able to carry out a correction at stage 1. In other cases, they only help to alleviate the condition.

In the orthopedic online store "Healthy Legs" you can buy an inexpensive corrector for hallux valgus.

Important: there are no folk methods and "grandmother's" recipes for treating bumps on the leg, only orthopedic remedies or surgery.

Types of surgery

Surgical treatment can be of several types:

• Minimally invasive - the entire operation is performed through a puncture without the use of special fixators, it is effective for mild and moderate severity.
• Reconstruction surgery is recommended for severe degrees of hallux valgus. Special fasteners are used to restore the anatomical position.
• Arthrodesis - is used for arthritic changes, with the establishment of complete immobility of the joint. It helps eliminate pain when walking and deformity.

During treatment, the doctor restores the correct position of the joint, removes bone growths, and also fixes the motionless deformed area.

Another type of hallux valgus is the so-called scarf operation. During the operation, a wedge-shaped area is removed from the bone of the big toe, then the edges are compared.

Minimally invasive treatment

Tests for surgery hallux valgus

Before the day of the operation, an x-ray of the foot is taken in a standing position, projection (direct, lateral).

Tip: the day before, exclude all thermal procedures (bath, sauna, hot bath), massage, workouts, fatty, fried, sweet, spicy, alcohol (3 days), some types of drugs (antibiotics, diuretics, hormonal) need a doctor's advice.

Standard tests:

1. General analysis:

• urine (morning);
• blood (on an empty stomach).

1. Group and Rh factor of blood.
2. Biochemical analysis of blood from a vein (the specific list will be specified in writing, it is different in all clinics).
3. Syphilis.
4. Hepatitis.
5. Coagulogram (analysis of the blood coagulation system).
6. Fluorography.
7. Electrocardiogram with description.

How is the operation

In the case of minimally invasive intervention, all manipulations are carried out under X-ray control. The task of the surgeon is to remove the bone growth through two punctures and restore the necessary axis of the metacarpal joints. The main disadvantage is the possibility of the return of pathology.

Results after big toe surgery

In a reconstructive operation, spokes are used (in neglected conditions), screws, plates (brackets). They help to keep from deformity, as well as to maintain the correct position of the bones after an osteotomy.

• Basically, they operate under local anesthesia in the cerebrospinal fluid of the spinal canal, but they also do anesthesia. An interview with an anesthesiologist is required.
• Duration: 30 minutes to 1 hour.

It is important to understand that establishes the need for surgical intervention, only a specialist. No matter how much you want to quickly get beautiful legs, if there is no indication for surgery, then conservative therapy will be a priority.

Indications for the operation.

1. Pain in the joint of the thumb.
2. inflammatory processes.
3. Severe deformities of the bones and the foot as a whole.

Contraindications

Despite the importance of such treatment, there are diseases in which the operation is strictly prohibited, these include:

• diabetic foot;
• pathology of peripheral arteries;
• systemic diseases of the cardiovascular system;
• the presence of purulent inflammatory processes.

The first phase of menstruation is contraindicated, anesthesia can cause bleeding.

Arthrotic changes in the joints are not a contraindication, however, treatment is carried out taking into account the recovery period and the possibility of complications -.

Watch a short video.

Hallus valgus rehabilitation after surgery

Postoperative period

Recovery depends on the type of operation chosen and the individual characteristics of the person. All days in the hospital they pierce a course of antibiotics and painkillers.

On the very first day after surgical treatment, strict bed rest is recommended. To prevent severe edema, bandage the shin together with the foot with an elastic bandage for 6 weeks, swelling of the foot is allowed within the normal range.

Two weeks passed

It is allowed to move after three days, the patient immediately puts on special Baruk shoes, they even sleep in them and go home after 3-5 days, they wear them for six months, if there are no shoes, they put plaster. Buy a crutch, a walker to reduce the load on the operated leg, it will come in handy in the clinic and at home.

One dressing is done in a hospital, the next as it gets dirty, and in the absence of secretions, you should not touch the bandages at all. If necessary, it can be done at home, it is unlikely to be convenient to visit the clinic, or ask for a dressing at home (as agreed). Protruding knitting needles and seams are treated with alcohol or chlorhexidine. Water procedures are allowed after 3 days, after removing the stitches and removing the spokes, so as not to cause an infection.

Important: ointments, compresses on the seams, only with the permission of the doctor.

The stitches are removed after 12 days. If the fixation took place with knitting needles, then they should be removed after 3 weeks, the procedure is not difficult, anesthesia is not required. I process the wounds with greenery. With screws, plates (staples), everything is simpler, the structures are firmly attached to the tissues, so if they do not bother, there is no need to remove them, which also reduces the recovery period during rehabilitation.

Healing process in a month

Be sure to wear a semi-rigid corrector for 8 weeks (a month later) to move the big phalanx of the foot to the side, then replace it with silicone interdigital separators (inserts) that will hold tightly between 1 and 2 phalanxes of the fingers, they perform the same functions as the corrector .

For this time (3 months) pick up soft, comfortable shoes with a flat sole that would fit the toes with inserts.

Six months later, a heel up to 5 cm is allowed, but an insole is added under the forefoot, for transverse flat feet, the insert between the toes remains, it is worn for 7 months.

The online store has a large selection of interdigital silicone partitions.

In addition to restrictions in the postoperative period, you will have to follow certain rules when choosing shoes for the rest of your life; high heels are highly undesirable.

How to change bandages at home

You can enjoy walking without any devices after 1.5 months, and the possibility of playing sports and physical activity is decided strictly individually - it depends on the characteristics of the recovery period, the complexity of the deformity and how the operation itself went, whether there were any complications. At the same time, driving, cycling, swimming are allowed.

Fundamentals of the rehabilitation period

• Maximum provision of rest before the permission of the surgeon to activity.
• The use of anti-inflammatory ointments to improve healing and reduce the recovery period.
• Subsequent intervention should be carried out with a break of at least 3 weeks, provided that it is necessary to carry out on both limbs at the same time, discussed with the doctor.
• It is obligatory to maintain a special position of the big toe with the help of tight bandaging for 1.5 months, removing it for hygiene procedures and exercise therapy.
• Permanent wearing of special orthopedic shoes.

No matter how much you want to put on model shoes after surgery, you should still think about the recurrence of the disease. Beautiful fashionable shoes, especially narrow ones, with high heels under the strictest prohibitions. You should choose shoes in size, with sufficient fullness, with not large heels (by the way, the complete absence of a heel is also not recommended).

The results of the operation of hallux valgus, and mandatory rehabilitation, which lasts about 6 weeks, and the evaluation of the final results is 6-12 months.

The sick leave is opened in the institution where the procedure was performed. Extend the sick leave and be observed at the place of residence by the surgeon. Observation by a surgeon every 3 months during the entire recovery period after the operation of hallux valgus.

Valgus deformity of the feet - exercises

During the rehabilitation period, physiotherapy and exercise therapy help speed up healing and develop feet faster. Gymnastics is especially important for improving blood circulation and motor functions.

The simplest exercises can be carried out already on the first day after the osteotomy - moving the fingers several times during the day.

Exercise 1. Alternate stretching of the feet for several minutes.

Exercise 2. Self-massage - stretching and bending the thumb (without much zeal, please).

Exercise 3. Activities for activating movement - picking up a straightened towel or cloth with your fingers, rolling objects with toes.

Exercise 4. Roll the ball with the help of the feet, you can do both with two legs at once, or alternately.

Exercises 5. Performed only with the permission of the doctor (approximately after 6-8 weeks). Rise on toes with a stop at the highest point, and then slowly lower.

Listen to your feelings and strictly follow the doctor's instructions. If pain occurs at the time of doing gymnastics, you should stop exercising. The recommended rate is 3 times a day for 10 minutes. Combine at your choice, but rather consult your doctor if something does not work out.

Nutrition is of great importance at this moment, in order not to look for recipes, read the free book "17 Recipes for Delicious and Inexpensive Meals for the Health of the Spine and Joints." DOWNLOAD

On this article I will finish, we have analyzed the main surgical interventions for deformity of the thumb. Following the recommendations of the surgeon after the operation, rehabilitation is successful, the main thing is not to rush and be patient.

The son writes down his covers, listen to the chic performance Despite the fact that he found himself in music in a wheelchair.

Take care of yourself and your loved ones!

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!