Types of surgical intervention when the Smooth valgus

deformity of the hallux

Hallux deformity of the foot (Smooth valgus) – pathological processing of the first joint metatarsal-phalangienne. During the evolution of the disease after the thumb bend the other fingers of the foot. In the early stages of the therapy is widely used all kinds of orthopedic devices. In the case where the curator of the medicine is powerless, illustrated with a surgical intervention. The operation is Smooth valgus eliminates severe deformities of the foot. View of the surgery depends on the severity of the pathology and the presence of comorbidities.

The causes of the disease

Smooth valgus uncomfortable when walking and spoils the outside of the foot. In addition, the disease is able to disturb the blood circulation, causing the appearance of bursitis and arthritis. The Smooth appearance valgus may cause:

  • The violations in the endocrine system;
  • The weakening of ligaments;
  • The omission of the longitudinal axis and a transverse arch of the foot;
  • The age of the lesions of the tissues of the bones;
  • Genetic predisposition.

The medical practice is abundant evidence that Smooth-valgus more frequently seen in women who prefer to see it with the shoes and high-heeled boots. Often, the judgment turns to the representatives of certain professions, for example, among the dancers. There is the "nepotism" Smooth valgus quite often mothers and grandmothers, patients also suffer from this deformation. In men, the ligaments more flexible, and more tight, so Smooth, valgus, they diagnose for the most part after the injury.

The symptoms of Hallux valgus

the symptoms

The early stage Smooth valgus are inherent to the stiffness and discomfort when walking. The progression of the Hallux valgus is often accompanied by bursitis, the inflammation of the lining of the bags in the region of the joint, aggravating the course of the disease. There are also joint pain when walking and sometimes at night. They are different on the severity from barely noticeable to unbearable, cutting, or prolonged aching.

The shutdown loses damping function. The further evolution of the disease is capable of causing a change of the intervertebral disc and cause the manifestation of degenerative disc disease, osteoarthritis. The pain whining of nature in this phase Smooth valgus appear in the spinal post. Be without movement, the patient feels that he is falling asleep in the limbs, and gravity, and after driving load of the pain.

At the same time, the joint swells. Increasing, it softens the synovial folds. As a result, the cartilage is refined, the os forced to come into contact with each other. The wear of the articular surfaces leads to the appearance of osteophytes – outgrowths pathological tissue of the bone.

The development of the disease

The progressive development Smooth valgus, often, does not allow to diagnose the disease in its initial phase, when the violations pathological yet, you can edit it using traditional therapy and the use of special tools. A small joint at the base of the big toe is often think corn and trying to get rid of it using the usual methods. But with time, the "corn" more hardens and turns, causing pain when driving.

Excessive loads at the joint, causing inflammation of bone tissue. When the thumb is shifted by an angle of more than 30°, deform the toes. Podiatrists share during Smooth valgus in three steps:

  • I – finger moves to the outside at an angle of less than 25°, metatarsal bone to the inner – angle of less than 12°;
  • II – finger moves to the outside at an angle of 25°, metatarsal bone to the inner – angle of less than 18°;
  • III – finger moves to the outside at an angle of 35°, a metatarsus bone in it – an angle of 18°.

It is important! The degree of change in the structure of the foot is the main factor when you set the mode of surgical treatment Smooth valgus.

The indications for surgery

The main indications for surgical treatment Smooth valgus – pain syndrome, the development of inflammation and tissue injury of the bone. Hallux valgus can be cured by traditional means before the completion of the formation of the skeleton – only in children and adolescents. Adult patients and the course of the disease can only slow down: stop the pain, to take over some departments of the foot, and prevent the development of complications.

ways to treat

To solve the problem of the Smooth valgus allows for a surgical treatment. The plan of operation Smooth on the foot valgus was developed in the specific context of the patient – disease inherent to a variety of events and accompanying complications.

Types of interventions the operational

On the choice of method of surgical intervention influenced by the nature of the disease, the degree of adverse changes in the tissues, the existence of a serious counter-indications. There are over three hundred species of surgery at the Smooth valgus. All are divided into main groups:

  • Affecting the soft tissues;
  • An impact on the os;
  • Combining the manipulation on the soft tissues and bones.

Previously, during the operation of the Hallux valgus, excised the articular head. Similar traumatic impact generated by the result, abnormal function of the foot. Now surgeons prefer to do minus traumatica of the operation.

Providing the methodology

Minimally invasive operations are presented in the first stages of pathological processes. They assume the handling, slightly by acting on the soft tissues, and tendons. The goal-friendly practices – the reconstitution of the aesthetic and the liquidation of the discomfort when driving. These operations allow patients to recover quickly. But still the risk of hallux valgus violations in the future.

In the course of the operation are two of sting (3-4 mm) on both sides of the first toe. Using microtools, open joint bag, which is a disease that is often compressed. Its extension through the tiny incision gives space for the installation of the axis of the thumb in a physiological position. For the complete elimination of the curvature of the finger some of the bone rasp micro caedentes. During the implementation of the manipulation applies a control x-ray. Menus for the tabs are not used.

Reconstructive surgery

the deletion

When this form of surgical interventions produce a longitudinal incision of the length of 2-4 cm in the lateral region of the foot. The thumb settle in a physiological position. Bone growth liquidate, in the neighborhood of the joint of the thumb and the interphalangeal joint repair package.

On metatarsal bones act in several ways:

  • Austin, this is the same model of herringbone fabric (dissection V - or) – for the small displacement of the thumb (less than 17°);
  • Scarf (dissection Z-a) – when the medium and the forms of serious differences of finger (from 17° to 40°);
  • Akin (dissection wedge shape) – often combined with mini-invasive methods.

After osteotomy, the bone fragments are set using segments of titanium screws. They do not usually require extraction. If you encounter problems titanium strips away outpatient later than three months after the surgery.

Arthrodesis

This way the most radical surgery to the Smooth valgus on the bottom of the oa. When you create stationary of the joint. Are eliminated, and the syndrome of the pain, and morbo articulari laborans of the event and the deformation. The lack of joint mobility is not reflected on the approach of the patient and their activity.

Apply an arthrodesis, if other methods of treatment Smooth valgus have not brought the desired result. During the intervention of the fragments of attached hard link screws. Before you install the screws, remove the articular surface of the first interphalangeal joint of the head and the proximal phalanx of the first finger. Physiological structure of the foot is restored, the symptoms of the osteoarthritis disappears.

Contra-indications and complications

The surgical intervention is absolutely contraindicated in cases of:

  • Of serious vascular pathologies of the members (thrombo-atherosclerosis);
  • Effects on the system nervous priphrique (diabetic foot);
  • Infections;
  • The diseases of the hematopoietic organs.

When osteoarthritis and arthritis surgical treatment is possible. But, by choosing the way of the operation Smooth valgus, in the calculation to take the occurrence of any complications, as in the course of the surgery, and the recovery period.

After the operations Smooth valgus reconstructive nine types of complications can occur that are inherent open-cavernous interventions:

  • The infection of the tissue;
  • The formation of blood clots in the deep veins;
  • Aseptic necrosis of the head of the interphalangeal joint (very rarely);
  • The limitation of the functional activity of the first finger;
  • The violation of the nervous ligament;
  • The swelling is of an allergic nature;
  • A numbness of the extremities.

The complications are rare. Usually the patients after the surgery feel well, and to a young adult.

restoration

Restoration

After the rapid intervention of the patient is assigned to bed rest. The first day has allowed us to develop little by little the foot first to move his fingers. On the third day, you can look a little bit like. Your doctor will tell you exactly what to wear after the operation Smooth valgus. In a first time, only orthopaedic appliances (orthotics), which relieve the load of the sealing effect of the ball of the foot. Under the supervision of a doctor in a hospital, the patient is 10 days to 14 days.

Taking treatment of the water prior to the removal of points, it is necessary to roll the leg of polyethylene. Dressings can not drag and wet, otherwise it may produce a relapse of the disease. Walk without orthopedic devices is permitted no sooner than six weeks. In the area of the feet and lower divisions of the ankle up to three months after the operation Smooth valgus deformity may persist swelling. They take the cold compresses.

For the rapid recovery of the functions of the foot and healing post-operatively run apply:

  • Massage;
  • The electrophoresis;
  • Procedures shock wave therapy;
  • The physiotherapy exercises.

Later, two months after the operation Smooth valgus, the patient may recommend preventive, swimming and cycling. Full rehabilitation after an operation Smooth, a valgus takes four to six months. But from time to time of the leg should be set above the head. To load its not worth it. At night, you can use corrective bus. After the operation Smooth, valgus, it is recommended to perform a massage of the arch of the foot a ping-pong ball.

Postoperational will accelerate the rehabilitation of special footwear, designed for fixation of the joints of your feet and giving them a pressing effect. Wear a similar shoes, it takes less than three months. On the close of the uncomfortable shoes and high heels is better to forget it.

It is important! If necessary, the procedure on both feet, it is recommended to exercise with an interval of three to six months.

After an operation Smooth, a valgus of good practices of patients, almost immediately, are able to walk. But it is very important to entrust the operation to a qualified professional and perform all of its recommendations in the postoperative period.

11.09.2018