In the article, we discuss the functioning of the deformation valgus of the first finger of the foot, indications and contraindications for its implementation.You will discover what types of surgical elimination of the bone exist, how rehabilitation is, what complications are possible.The functioning of the valgus deformation of the first finger of the foot.Indications for the functioning of the valgus deformation.The disease called Valgus deformation is familiar to many - it is the formation of a bombed bone in the thumb of the foot.In addition to unattractive aesthetics, this pathology leads to considerable suffering, is dangerous by the development of irreversible changes in the first phalang plus foot of the foot until its complete destruction.
In the early stages of development in treatment, conservative methods are used - orthopedic correlators in combination with baths and ointments. If such therapy does not provide a result, a person with a valgus deformation prescribes an operation of the Valgus deformation of the thumb. Its type depends on the degree of development of the disease, the age of the patient and the presence of other general and local diseases, as well as the causes which have caused degenerative changes in the joint.Indications when the operation is required:
- The ineffectiveness of the conservative methods of therapy.
- 3 and 4 steps of pathology with inflammation and intense pain.
- Degenerative tissue lesions.
According to the scene where the joint tissue remains, the surgeon-orthopedist selects the type of operation with deformation of 1 finger valgus.
Types of Valgus deformation operations
When the thumbnail is diagnosed, the operation is used to expose only on soft tissues and tendons, to correct a defect in bone tissues or with a combined effect.In total, there are more than 3,000 types of surgical elimination of the bone - easy correction and therefore poorly invasive interventions in addition to the degree of damage to the phalanx more articulation, when choosing the functioning of the valgus deformation of the first finger, the general condition of the patient and the presence of other diseases are taken into account.The withdrawal is made under local anesthesia or general venous anesthesia - of the patient's choice.
Mcbride
McBride operation, other names: silver operation, transposition of the tendon, refers to mini-invasive interventions only informing soft tissues. In the process, the surgeon moves the tendon from the thumb removal muscles at the head of the bone I plus.As, therefore, the entire muscular-pursline balance of foot changes, and I and II, metatarsal bones are closer due to the formation of the numbering muscle, it cannot resist the overload of the foot and the relapse of the disease occurs very often.In fact, this operation temporarily eliminates only temporarily and suspends the development of deformation.
Seri
The osteotomy of the series also refers to saving interventions, it is short in duration. In the process, the distal cut of the distal metaphytes of the first bone plus (cones) with an additional bone fixing with a knitting needle, which is inserted through the thumb, is carried out. Then, a special boot for the rehabilitation period is allocated.The function of seri of the deformation valgus of the first finger of the foot, according to criticism, gives a notable result, the postoperative period is short, after you can go to ordinary shoes.The effect is long, the probability of relapses is low.
Chevron
Osteotomy Chevron or Chevrony in the shape of a V (Chevron Osteotomy) or-a mini-invasive operation used only with small deformations (the angle of movement of the thumb up to 17 degrees) and without concomitant pathologies (arthritis, osteoarthritis). In the process, two small cuts are produced, the ligaments and the joint capsule are offset, the bone corn is removed, then the phalanx is fixed using a titanium wire or a titanium screw. If necessary, the wire or screw is removed after 3 months.The whole operation is carried out under the control of the Eop-Randgen.The effectiveness of the operation is high, relapses rarely occur, but due to the complexity of the intervention itself and the requirements of a very high qualification of the surgeon, it is rarely used.
Scarf
The scarf osteotomy (scarf, z -shaped) is used for a moderate and severe shape of deformation of 1 more bone of the foot, with an angle of inclination of the finger at 40 degrees. The process is carried out through a cut of the foot at the base of the bone more.There, a z -shaped corner is cut and the phalanx head is moved to the right position.In parallel, the position of the tendons and the joint capsule is replaced. This position is fixed with two miniature titanium screws.In most cases, they are not extracted, because the patient feels no discomfort.In surgery, this is the most commonly used operation in the diagnosis of valgus deformation of the thumb of the foot.Critics speak of rapid healing after surgery, minimum scarves, a short period of rehabilitation.The effect is excellent, in the long term, relapses are extremely rare.
Arthrodesis with deformation valgus
Arthrodesis or lapidus operation - The closing of the medial joint is used in serious complex deformations, which are accompanied by particularly high articular mobility.It is a radical operation in which the complete immobilization of the more clinovic joint is carried out. To do this, the bones that form it are closely connected by 2 titanium screws of a special shape in the longitudinal position. This complex operation is only used if other species cannot give a positive result.After arthrodesis, deformation is completely eliminated, manifestations of osteoarthritis and pain disappear.The immobility of the articulation does not affect the patient's approach, but it is impossible to wear shoes with heels.Little by little, with the use of medication and physiotherapy, the structure of the joint and the foot is completely restored.The results are positive in 98% of cases.Depending on the journals, the radical deformation of valgus of the thumb of the foot with the operation of the arthrodesis allows you to restore the functions of the foot even in advanced cases
Deformation operation of the finger
Apply for various deformation degrees of 2 to 5 fingers, according to that, the type of surgical intervention is selected.It may be an unacceptable violent elimination closed of joint contractures and axial deformations of the extremities in stretching and partial rupture of the soft tissues, by modeling or in complete resection of the heads of the metatarsal bones and the phalanxes, by moving (transposition) and in cross (tenotomy) of tendons, oste more in position).The correct position of the fingers is fixed with the knitting needles or the Herbert screws.The desired result for a long time can be obtained in 85% of interventions on the curved fingers.Pain and discomfort when wearing shoes decreases or disappears completely.The correction of the deformation valgus of the fingers of the foot with the operations of this type gives a good cosmetic result.According to statistics, complications are not more than 2 to 3% of surgical interventions.The forum dedicated to the valgus deformation of the thumb of the foot is filled with journals of the effectiveness of operations to eliminate cones.
Rehabilitation after surgery
The postoperative period is divided into several periods.Rest in bed in the clinic lasts 2-3 days.Already 5-6 hours after the operation, the development of the leg begins - the fingers move.From the third day, you should get up and walk using special barok shoes, then orthopedic orthosis, which eliminates the load of the operated joints.With certain types of operations (arthrodesis), time in the hospital can be extended up to 10 days.The second step is the healing and restoration of the leg support function.It lasts 3 to 6 months.Currently, swelling of the foot and ankles can stay.To mitigate the condition, you should relax with your high legs.Fresh grass compresses are also effective.One month - two, on the recommendation of a doctor, you will have to walk with crutches so that the joint does not suffer from the load.Until the seams are cured, the water procedures must be carried out by protecting the leg with a linked plastic bag.Physiotherapists are also prescribed: electrophoresis, shock waves therapy.Massage begins to be used as soon as possible after surgery and physiotherapy exercises - after 2 months.Most often, it is the development of the foot, an exercise bike, swimming.To support the joint in the right position, it is necessary to use a tire of hard night valgus.During the day, orthopedic shoes are worn, the term is at least 3 months.Wearing a heel is authorized at the earliest 6 months after surgery, a height of less than 4 cm.Sports can also only start 6 months after the removal of the deformation.
Contraindications to the operation
Restrictions on surgical treatment of bones on the leg are not very extensive:
- Pathologies of members' vessels - Varices 3 and 4 degrees, thrombosis, erase atherosclerosis;
- Diabetic foot;
- oncology;
- Purulent infections and acute inflammation.
What to remember
- With bones on the legs, the operation is prescribed if conservative methods do not help or if the disease is launched.
- The effectiveness of operations is high, complications are rare.
- The sooner you start the treatment, the easier the operation and the rehabilitation.