The formation of valgus from the toes is very common that in medical practice you can count more than four hundred options for the solution of this problem.Of course, not all interventions are the same success and solve patients' problems, so in modern practice the most progressive options for permanent intervention, where the patient's recovery opportunities are high.Today, Khalus Valgus' operation is focused as a lower invasiveness that is possible in combination with good therapeutic effects from the intervention.
Indication
Khalus Valgus is a problem not only for adults, it can also appear in children.The formation of a cone in the foot of the thumb in the early stages does not interfere with the patient until a sharp pain occurs during walking, problems with shoe selection, periodic inflammation.At this stage, most patients try to relieve pain with folk methods.Various compression and bathing only tighten the course of the disease and lead to one real solution of valgus deformation - surgical intervention.
The clues to the operation are:
- increased pain in the toes;
- Chronic inflammation, which cannot be stopped, persistent swelling;
- damage to the skin in the curvature of valgus (crack, suppuration, ulcer);
- Plana valgus foot with clear curvature from the thumb joints;
- inability to help patients with conservative methods;
- Gait appearance is paralyzed;
- Limit motor activity in the foot.
Doctors emphasize the treatment of Valgus Thumbs exclusively surgery, as most patients turn to the disease level when it is not possible to correct the pathology.At the same time, if you do not start bone treatment on the feet, it will eventually lead to redistribution of loads on other fingers, which is why the finger will suffer and bend from second to fifth.Only with timely surgical intervention, such complications can be avoided.
Preparation for intervention
During surgery to deform the valgus of the toe joint, serious preparation is carried out in the orthopedic.The patient runs all necessary tests.Their key is a blood test, according to the important results to exclude the signs of inflammation in the body.
In some cases, the list of standard analysis can be supplemented by determining the level of hormones and markers for oncology if the doctor suspects the development of the malignant process in the leg.
The compulsory level in orthopedic surgery is the diagnosis of X -Ray - during the study, the picture is taken in two projections to determine the deformation and severity of pathological disorders.
In difficult cases, doctors can use magnetic resonance or computed tomography.Such studies provide more accurate results.According to the analysis, the doctor decides in the best way to perform the operation.
Classification of surgical intervention
All operations performed by Valgus can be divided into two large groups - invasive operations and reconstructive intervention.The first type of foot surgery intervention is characterized by low trauma.
The operation is limited - only in the early stages of the development of the disease, if the deformation is not important and in the presence of benign cartilage growth, which is easily released through surgery.In all other cases, minimal invasive surgery does not solve the patient's problem.
Most of the minimal invasive interventions are done quickly and do not cause complications.The scars after such operation are minimal.Doctors make from two to three punctures, the length not exceeding 0.5 cm.After this operation, the skin is restored quickly, and the duration of inability to work is up to two weeks.
During reconstructive intervention, the amount of damage to the soft tissue is more important.However, the large additional operation is that they help eliminate even significant foot deformation and help with severe curvature.The incision in reconstructive intervention reaches up to four centimeters, it is located next to the medial foot.With such surgery, the doctor completely restores the anatomical position of the toe.
You can also consider operations depending on the location.Three groups of interventions are distinguished - on soft tissue, on bone tissue and combined surgery.When performing the intervention on a soft cloth, it is possible to eliminate valgus deformation only if no bone head deformation is added.In the course of such interventions, the doctor works exclusively with soft tissue - tendons, muscles, bottles.
With surgical intervention on bone tissue, it is possible to correct the second and third stage deformations.The intervention is to file part of the bone or to carry out osteotomy.With combined operation, intervention occurs in soft tissue and bone.But the possibility of such surgery is broader - doctors can simultaneously produce bone growth and make ligaments.
Technique
Some operating techniques can be eliminated on the feet, each with its own advantages and is selected with certain indicators.
McBride Operations
With surgical intervention, McBraid was performed in the first interval at the head level.Using clamps, doctors spread soft cloth and make ligaments between flowers, located on the surface.Subsequently, the surgeon had access to the muscle tendon, which was responsible for the first finger allocation - it was moved and stitched by a special stitching material - Vikril.
Further, the doctor works with a bone -shaped bone, he crosses the deep bundle attached to the bone -shaped bone, which is eliminated by his subluxation.Then, the plusphalanx joint capsule is surgical on the outer surface, after which the incision is made on the inner surface of the foot about 5-6 cm long, the nerves are released through it and it is moved to the side.
Capsule surgery is performed in the form of English V, and the top is directed towards the thumb.From the top of the bone and underneath, the homeman's hook is removed beneath it, the growth of the cartilage in the metatarsal bone is removed.If this is not done, the patient in the future will experience pain in the joints.
In the future, the development of operations can occur in two ways, depending on the need for osteotomy.With osteotomy, there is a need to use talking that will attach tendons to bone fragments.In the final stage, excess capsule tissue is removed, plastic with certain tension of the tissue is performed, after which the surgeon sews the wound edge and process the surface.
Such techniques have been proposed more than eight decades ago, but to this day the operation has not lost its connection.Until after the intervention there is no relapse, after surgery, the patient is recommended to wear special orthopedic shoes.
Technique
Operating Techniques for Little Invasive Techniques were proposed in 1998 by Cesare Faldini surgeon.It is also actively used in doctors' surgery in many countries.It refers to low -trauma and effective procedures in the early stages of disease progression and with moderate foot valgus curvature, when the angle of the toe does not exceed more than forty degrees.
REFERENCE!This operation is not performed due to severe arthrosis.Also, patients can reject this type of intervention with the first metatarsophalangeal joint instability.
Foot operations are carried out under local anesthesia.Doctors make slices in bone head projection plus thumb, open capsules together, perform osteotomy with special files or chisels.In the process of such a procedure, you can achieve the redistribution of load on the distal bone part.
During the surgical process, doctors used a knit needle to make the right position from the thumb - they started on the medial surface of the surface in the spit, after which the doctor brought the finger in manual mode and set it in the correct position.Operations in the recovery process require wearing gypsum clothing - it is used for at least two weeks.Talking removal is done after about 1-1.5 months.
Chevron technique
Chevron techniques are used for small deformation if the angle is less than 17 degrees.The main conditions for the implementation of such interventions are the lack of arthrosis and other serious changes that valgus are provoking.
The treatment is performed as follows - in the early stages, the doctor cuts the skin directly on the joints that wrap it.The shortened connection and the capsule together itself are distinguished.Usually degenerative changes in tissues and ligaments trigger thumb deformation.Bone corn at the joints is removed using a chisel or file.
In the metatarsal bone, the slice is done on the head floor, it turns outside and mounted under the sesamoid bone.Then, with the help of screws or wires, the phalanx is attached, and the capsule is closed.After surgery, the titanium screw does not require removal, but they eliminate the wire three months after the surgery, if not necessary to do this early.
Scarf
In most patients, you can remove the bones in the feet using the oosteotomy.Such surgery is performed with a moderate deformation of the first leg of the toe.To date, operation is the most universal method for treating valgus, it has many advantages compared to other methods.
The positive aspects of operation are as follows:
- In this process, it may not only be to move, but also to make the bone head added, which allows you to achieve more progressive results than with other surgical interventions;
- Doctors can with insufficient value to perform long procedures;
- With variety deformation, you can move the bone to the medial part;
- To reduce the load on the inside of the foot and the first finger area, you can move the bones slightly down and to the side;
- If necessary, you can shorten the length of the bone;
- When cursing joints, bone elements can be rotated.
Surgical intervention is performed under spinal anesthesia.The surgeon on the inside of the foot makes the cut from the beginning of the finger to the beginning of the metatarsal bone.Subsequently, a zigzag -shaped slice was made on the first side of the finger, after which the bone head turned to the desired position, the corner changed.At the same time, the doctor changes the location of the tendon, which is attached to the thumb.
Then, the defective joint capsule is separated from the outside and the bone is set in the required position using a titanium screw.Usually, the fastener is not removed, if they do not bring any discomfort, then the patient and then go with screws.Recovery after surgery takes three to six weeks.Immediately after the intervention, the patient is recommended to wear special orthosis or tires, where it should load as early as possible.The tires rush all the time while the recovery period passes.
Laser intervention
The elimination of valgus deformation with laser is also possible, however, the patient cannot be expected for such surgical methods.Although it is minimal and gentle, it is used exclusively in the early stages of the development of the pathological process.
The advantages of undeniable surgical interventions are small size, where doctors make near the largest point on the bone cliff.After healing, such injuries are invisible, which allows you to restore as much aesthetics as possible.By using lasers, doctors have the opportunity to carry out limited interventions:
- Existectomy is carried out - with the help of laser, part of the cartilaginous growth is released, formed in the early stages of valgus;
- Make osteotomy with large pieces - in the surgical process, the first proximal phalanx is removed;
- Performing arthroplasty resection - the articular surface of the bone is added and part of the thumb phalanx is removed.
Laser removal is usually carried out in a clinic where there are special equipment.Recovery after surgery is minimal - within a few weeks, the patient can walk normally.
The only weakness of laser intervention is that the wrong position of the bone is not subject to correction, and it only grows under the desired parameters.In this case, the patient is threatened with relapse.
Arthrodesis
The operation to eliminate valgus by arthrodesis is used quite rarely, but sometimes this is the only way for patients to get rid of large toes.This operation belongs to the most radical intervention method.
With the help of such surgery, it is possible to remove the base of the first finger phalanx and fix the finger with a special screw.
IMPORTANT! During surgery, the main goal is achieved - eliminating deformation and giving the right position joints, but not all patients become comfortable after the surgery.
There is a serious contraindication for intervention:
- vascular atherosclerosis and other blood circulation disorders;
- Diabetes feet;
- Polyneuropathy.
With arthritis and arthrosis, the patient can also reject surgery if the joints are very defective, destroyed, constantly inflamed.In this case, the patient will advise a slightly invasive surgery.
Among the complications of surgical intervention, the following pathologies may occur-pain, discomfort due to bone-mounted titanium binding structure.Recovery after an eight -week intervention.Walking in the gypsum is only necessary on the first day after surgery - this is necessary to set the elements.You can use Baroka boot.These are specially designed orthopedic shoes that will remove the load from the handled foot.
Comment
If the patient has surgery to eliminate valgus, he or she is able to read the review and find out the type of intervention it is and how effective they are.Here are some similar opinions:
"Last year, I had to finish Ballerina's career because of the deformation of the finger valgus.
"I've been suffering for a long time, but I have not dared to go to surgery, I have become a complex arthrodesis, recovery takes more than two and a half months, but after the operation is easier. Now I can walk without a stick and not torture pain."
“The bones in my feet are offspring - even though my mother and grandmother suffered gout.
Valgus deformation operation in most cases allows one to solve bone problems on his finger.When the first signs of valgus appear, do not delay the treatment - the best results appear in the early stages of the disease development.