A great risk to the curvature of the foot it is seen in people who have a tendency to articulate pathologies I was wearing shoes uncomfortable. A disease in which the bone that protrudes from the first joint of the big toe called hallux valgus. Due to the deformation of the foot that affects women frequently. To correct the distortion, and necessary to remove halyus valgus, operation is performed using 3-4 stages of the disease. The frequency of occurrence of pathology depends on the age of the person. Foot a warp starts with prolonged use of shoes with claws high. The process has a duration of several years. To change the width of the foot and most often observed in middle and old age.
They say that The doctors of the surgery to correct the foot and a procedure sense which is impossible to do if the bone has acquired a large size, it prevents me from walking. A blow to the leg prevents the movement. The main sign of the progression of hallux valgus and the pain. The deformity seen in people with feet of flat and a long metatarsal bone. Treatment of the pathology halyus valgus deals with the podiatrist. Helps to restore the position of the foot normal and to avoid examining the bone.
Stage of the pathological process
The decision of whether the operation takes place halyus valgus, the doctor accepts. He drew attention to the degree of curvature of the foot. 2 In the early stages of the disease, the conservative treatment is performed. If the correction is impossible, that requires surgical intervention. There are 4 degrees of severity halyus valgus:
- In the first stage. The restaurant the angle of deviation of the metatarsophalangeal joint no weight 15 degrees
- In the second stage. It is characterized by the appearance of small but perceptible cops. The restaurant the angle of deviation and 15-20 degrees
- In the third stage. The bone in the foot becomes severe, inflamed at the time of walking, and wear tight shoes. The deviation from the union and from 20 to 30 degrees
- The fourth stage. It is characterized by pain and complications. The restaurant the angle of deviation metatarsophalangeal joint of the exceeds 30 degrees.
In the initial stages of the disease, surgery of the hallux valgus the first toe, a necessary head. In these cases, the issue can be resolved by surgical intervention sense. If the load on the legs will not be reduced, there will be the curvature of the foot. As the progression of the disease, thumb increasingly veers towards the interior, while the set – out. As a result, the foot s expands. In the later stages of hallux valgus and constant swelling in times of foot. The pain appear not only during walking but also at rest.
Indications for surgery
Original works of art for the realization of diagnostic procedures, surgeon orthopedic to decide if the surgery on the foot in hallux valgus. Surgical treatment of the feet of curvature is performed while the joint deviation of more than 20 degrees. Strongly protruding halyus valgus a foot in an adult will not work independently. Therefore, the operation with the deformation of grade 3 and 4 – a question of time. Pronounced, The curvature of the base of the foot in the absence of pain and inflammation, is related to the indications for surgical intervention. If you bring physical discomfort hallux valgus, hallux valgus operation the toe gros and necessary. Before carrying out the surgical treatment, conduct some research.
There are the following indications for surgical intervention:
- Frequent and severe pain in the region of the base of the thumb,
- The development of the inflammation when wearing the shoes,
- Swelling thumb of the
- Walk plan
- The absence of effect of conservative treatment methods
- The appearance of complications.
Before you start the treatment, the doctor, the patient and discuss the "pros" and "cons" operation halyus valgus. The patient should understand that the surgical intervention will help to dangerous to prevent to examine the effects of the strain. Complications to the curvature of the foot are: the formacio of ulcers on the surface of the deformation joint, bone infection, gait disturbance.
Contraindications for operators of treatment
There are cases in which restore the shape of the foot with the surgery and impossible. These include the disease of serious vital organs. Surgery of the hallux valgus of the first toe contraindicated if the patient has significant changes in the analysis. In order not to remove the bone is not recommended, if the restaurant is the angle of deviation of the binding and of less than 20 degrees. Absolute contraindications for the operation halyus valgus include the following States:
- Violation of the blood coagulation system,
- Decompensation of diabetes,
- Acute failure of the cardiovascular and respiratory systems, and,
- Uncontrolled hypertension,
- Thrombophlebitis of the veins of the lower extremities,
- Chronic diseases of the system osteoarticular.
To detect the presence of contraindications original works of art make the shows the biochemical and General blood tests, coagulation, x-ray of the foot of the chest. The surgery may not be banned, but before you run it that it should receive treatment. Among the contraindications of family: acute infectious diseases and worsening chronic inflammatory diseases.
Methods of surgical treatment
There are different types of operations halyus valgus. The choice of a method of a particular treatment depends on the degree of deformation and condition of the patient. Assign minimally-invasive and open surgery. Depending on the phase of the deviation of the thumb distinguishes the following methods of surgical treatment:
- The manipulation of the tissues of the foot soft,
- The osteotomy proximal and distal
- Surgery Lapidus,
- Keller Arthroplasty.
There are some 200 varieties of surgical interventions on elimination of valgus deformation. All treatments aimed at the correction of the curvature of the metatarsal bones. The purpose of each one of the operations of the a the removal of the bone at the release of the foot and the patient of pain. How to restore the normal form of the foot podiatrist.
A minimally invasive procedures include the surgery. S include the excision of bone tissue. The recovery of the original image hallux valgus surgery this kind of and very quickly. Percutaneous removal of bumps on the leg is shown in the cases in which the curvature is not very pronounced.
The manipulation of the soft tissues found in the dissection of the muscles and ligaments of the foot. That are carried out in small deformations, and also in cases in which the intervention in the organs of the bone is contraindicated. One of the varieties of the manipulation of the soft tissues in the surgery McBride.
Osteotomy a surgical procedure that involves artificial in a fracture of the bone metatarsal and fixation in the desired position. Depending on the severity of hallux selected the particular technique of this operation.
Interbody fusion in the validation of the joint position on the right. Applied during the deformation 3-4 degrees. To get rid of the bones performed arthrodesis according to Lapidus – this means that the joint is fixed in its position by means of special devices of l'. Remove halyus valgus and possible with surgery Keller. It consists of the resection of the tissue affected of articulating surfaces and fixation of the metatarsal bones. Is done in rare cases, such as the mobility of the big toe of this procedure original works of art and violated.
Each operation is different and special and of the surgical technique. To remove halyus valgus ca medpolicy, and necessary to the registrar and to pass all the exams. The surgeon should discuss in advance tactics operating on the patient. Warn the patient that the day is scheduled for the intervention and as of and the long period of recovery.
Preparation for surgery
Before the surgery, the doctor prepares for the procedure. And for a diagnosis of studies. Some days before the operation you must perform:
- The KLA,
- Biochemical Analysis of the blood,
- X-rays of the foot in the lateral projection,
- Of the test of HIV, syphilis and hepatitis.
A criterion of the doctor patient and deal with the question of the conduct of the anesthesia. If you want to not stop to remove the bone invasive method, original work of art carried out with local anesthesia. In the absence of contraindications and the patient's wishes to cut the knot under General anesthesia. Anesthesia intravenous is done in cases in which it is expected to open surgery. Comments on the functioning halyus valgus in most cases positive. Almost all patients reported they felt no discomfort during the procedure in spite of local anesthesia.
Operations on the soft tissues
Excision tissues of the soft foot of the s used as a treatment of hallux valgus. The indication for this method of operation and the deviation of the gold and less than 25 degrees. This method of treatment, a it is often combined with other surgical procedures. The varieties of interventions in the soft tissues of the foot, corresponds to the operation of McBride.
This surgical technique of manipulating muscle dissection, leading the thumb. With this procedure, the bone accepts the correct position. Original works of art excluding muscle carried out the removal of the capsule of the joint side of the side. The tendon and sutured to the head of the metatarsal bone. This procedure leads to the un to ensure the fixation of the thumb. Original work of art Rehabilitation surgery halyus valgus jade a few months.
Technique of interbody fusion
Possible Un method of treatment of the surgery hallux valgus and Lapidus. It is the interbody fusion metatarsophalangeal joint. To correct the curvature of perform the replacement cartilage. The joint to give a position and physiological fix it with a special square.
Shoes orthopedic original work of art from the surgery halyus valgus to wear for 8 weeks. Need special shoes of which help to reduce the over loading forefoot. Arthroplasty according to Keller almost never used.
The osteotomy proximal and distal
Osteotomy performed with an important deviation of the big toe. The essence of the operation of the to carry out the un's bone with the fracture subsequent fixation in the desired direction. Distal Chevron osteotomy of the s used the most often. It is made in the form of V of the fractured metatarsal bone. Then, and the lateral movement of lock and screws compression. The suture surgical removed 2 weeks original work of art. All of the patients are shown in the therapy and massage original work of art physical of the surgery halyus valgus.
The osteotomy proximal is done through the dissection of tissues from the foot to the base of the big toe to the metatarsal bone. This method of operating, if the deviation offers a higher than 40 degrees. Original works of art of the dissection of the tissue Z produce in the form of cutting of the bone and original works of art participate in a bow with the screws of titanium.
Complications original works of art for a surgical treatment
In exceptional cases, there are complications of the surgery. That can occur the during'acte of executing surgical or recovery period. Possible complications include:
- Damage to the piegaro standing
- Thrombosis of arteries and veins of the legs
- The infection of the tissues of the feet,
- Necrosis aseptic of the metatarsal head
- Numbness of the thumb.
The postoperative period has successfully passed, and important to follow all the recommendations of the doctor. The activity of the union and restored, slowly, so that the burden should be minimal. Original works of art from the merger of the bone sample of physiotherapy. The cost of the surgery of the hallux valgus of the big toe to the type of dependent on surgical intervention. That varies between 20 and 55 thousand virtually any.
The recovery period
The result of the operation was un successful in the early days of the foot is fixed in one position. In the early days of the movement of the legs limit. Original work of art stihaniya of pain syndrome prescribe massage un feet.
In the joint on movement, and necessary to develop for several months. For this purpose, all patients are recommended the un set of special exercises of the. Only Gymnastics and permitted original works of art original works of art for 3 months of the surgery. Up to that time, the joint will develop with the movement and continuous passive massage. Exercises for the toes of the original work of art hallux valgus surgery performed in a few months. They should not have a heavy load to the joint. The gymnastics of the flexion and the extension of the gold, the muscle tension of the foot. The rehabilitation period and at around six months. Original art works of 6 months, the patients return to normal physical activity.
To restore the functions of the foot patients wearing shoes orthopedic special with templates. And necessary that the loading principal is distributed on the rear foot. Orthopedic original work of art ear surgery in the foot is recommended to wear a few months before their recovery was full.