In the article, we discuss the function of deforming the valgus of the first toe, indications and contraindications for its implementation.You will find out what types of bone surgical elimination exist, how rehabilitation goes, which complications are possible.The functioning of the valgus deformation of the first toe.Indications for the functioning of valgus deformation.The disease called valgus deformation is known to many - this is the formation of a swollen bone on the big toe.In addition to aesthetic maltreactivity, this pathology leads to significant suffering, is dangerous from developing irreversible changes in the first plus-foot of the foot until its complete destruction.
In the early stages of development in treatment, conservative methods - orthopedic correlations are used in combination with baths and ointments. If such therapy does not result, a person with valgus deformation describes a deformation operation of the thumb valgus. 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 that caused degenerative changes in the joint.Indications when surgery is required:
- Inefficiency of conservative therapy methods.
- 3 and 4 stages of pathology with inflammation and severe pain.
- Degenerative tissue lesions.
Depending on the stage at which the articular fabric stands, the surgeon-orthopedist chooses the type of operation with valgus deformation of 1 finger.
Types of Valgus Deformation Operations
When diagnosed the thumb table, surgery is used to expose only to soft tissue and tendons, to correct a defect in bone tissue or with a combined effect.In total, there are more than 3,000 types of bone surgical elimination - from easy correction and thus - invoke minimal invasive interference to articular heads and even the whole joint with a substitute for artificial endoprostese.In addition to the degree of damage in the plus-chapal of the joint, when choosing the function of deformation of the valgus of the first finger, the general condition of the patient and the presence of other diseases are taken into account.Removal is performed under local anesthesia or under general venous anesthesia - with the choice of the patient.
Mcbride
McBride operation, other names: silver surgery, tendon transposition, refers to minimal invasive interventions affecting only soft tissue. In this process, the surgeon moves the removal muscle tendon of the thumb to the bone head of Plus.Since as a result, the entire equilibrium of the muscle-pretheline of the foot changes, and I and II, the metatarsal bones approach due to the formation of the call muscle attraction, it cannot resist the overload of the foot, and the relapse occurs very often.In fact, this operation only temporarily eliminates the pain and suspends the development of deformation.
SERIES
Osteotomia series also refers to saving interventions, is in short duration. In this process, the distal cut of the distal metaphysis of the first bone plus (cones) with further bone fixation with a knitting needle, which is inserted through the thumb. Next, a special boot is assigned to the rehabilitation period.The series operation of the valgus deformation of the first toe of the foot, according to the reviews, gives a noticeable result, the post -operative period is short, as you can switch to ordinary shoes.The effect is long, the probability of relapses is low.
Chevron
Osteotomia Chevron or Chevrony V-in-V-shaped (Chevron osteotomie) or a minimally invasive operation used only with minor deformities (angle of thumb displacement up to 17 degrees) and without simultaneous pathology (arthritis, arthritis). In the process, two small incisions are produced, the ligaments and the joint capsule are displaced, bone corn is removed, then Phalanx is fixed using a titanium wire or titanium screw. If necessary, wire or screw is removed after 3 months.The whole operation is performed under the control of EOP-antgen.The effectiveness of the operation is high, relapses rarely occur, but due to the complexity of the interference itself and the requirements of a very high surgeon qualification, it is rarely used.
Handkerchief
The scarf osteotomy (Z -shaped scarf) is used for moderate and severe deformation form of 1 plus the bone of the foot, with an angle of slope of the finger at 40 degrees. The process is performed through a cut from below the foot to the base of the plus bone.There, an Z -shaped wedge is cut and the Phalanx's 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, as the patient does not suffer any discomfort.In operation, this is the most used operation in diagnosing deformity of the big toe valgus.Reviews speak of rapid after surgery, minimal scarves, a short period of rehabilitation.The effect is excellent, long -term, relaxation is extremely rare.
Arthrodesis with valgus deformity
Arthrodesis or Lapidus surgery - the closure of the medial joint is used in severe complex deformities, which are associated with particularly high joint mobility.This is a radical operation in which complete plus-clinovic node is performed. To do this, the bones that form it are tightly connected to 2 titanium screws of a special shape in a longitudinal position. This complex operation is used only if other species cannot give a positive result.After arthrodesis, deformation is completely eliminated, manifestations of arthrosis and pain disappear.The inability of joining does not affect the patient's walking, but it is impossible to wear heel shoes.Gradually, with the use of medication and physiotherapy therapy, the structure of the joint and foot is completely restored.The results are positive in 98% of cases.According to reviews, radical deformity of the big toe valgus with the functioning of arthrodesis allows you to restore foot functions even in advanced cases
Finger deformity operation
Apply for varying degrees of finger deformation 2-5, depending on this the type of surgical intervention is chosen.This can be an unacceptable violent elimination of joint contractions and axial deformities of the extremities by extending and partial soft tissue rupture, modeling or complete reset of metatarsal bone heads and phalanges, moving (transposition) and transition (tensomine) of tendons,the inclination of their head tendency (ostoomoomoomoomoomoomoomy. The exact position of the fingers is fixed with knitting needles or herbert screws. The desired result for a long time can be achieved in 85% of the interference on the curved fingers. Pain and discomfortOperations of this type give a good cosmetic result.
Post -operative rehabilitation
The post -surgery period is divided into several periods.Bed rest in the clinic lasts 2-3 days.Already 5-6 hours after surgery, foot development begins - fingers move.From the third day, you need to get up and walk using the special baroque shoes, and then orthopedic orthosis, which remove the load from the operated joints.With some types of surgeries (arthrodesis), the hospital time can be extended up to 10 days.The second stage is the healing and restoration of the foot support function.It lasts from 3 to 6 months.At this time, swelling of the foot and ankle may remain.To ease the condition, you need to rest with your raised feet.Cold grass compresses are also effective.One month - two, with the recommendation of a doctor, you will need to walk crutches so that the lock does not suffer from load.Until the stitches are cured, the water procedures should be performed by protecting the foot with a tied plastic bag.Physiotherapists are also prescribed: electrophoresis, shock wave therapy.Massage begins to be used no earlier than one month after surgery, and physiotherapy exercises - after 2 months.Most often this is foot development, an exercise bike, swimming.To support the knot in the right position, it is necessary to use a hard tire of the valgus night.During the day, orthopedic shoes are worn, the term is at least 3 months.The heel coating is allowed no earlier than 6 months after surgery, a height of not more than 4 cm.Sport can also begin only 6 months after the elimination of deformation.
Contraindications to Operation
Restrictions on the surgical treatment of bones in the legs are not too extensive:
- Limb vessel pathologies - varicose veins 3 and 4 degrees, thrombosis, destructive atherosclerosis;
- Diabetic foot;
- oncology;
- Purulent infections and acute inflammation.
What do we remember
- With bones, surgery is described if conservative methods do not help, or the disease is launched.
- The effectiveness of operations is high, complications are rare.
- The sooner you start treatment, the easier surgery and rehabilitation.