In the article, we discuss the operation of the valgus deformation of the first finger of the foot, indications and contraindications for its implementation.You will find out what types of surgical elimination of the bone exist, how rehabilitation goes, what complications are possible.The operation of the valgus deformation of the first finger of the foot.Indications for the operation of valgus deformation.The disease called valgus deformation is familiar to many - this is the formation of a bulging bone at the thumb of the foot.In addition to aesthetic unattractiveness, this pathology brings considerable suffering, is dangerous by the development of irreversible changes in the first plus-phalang of the foot of the foot up to 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 bring a result, a person with 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 that caused degenerative changes in the joint.Indications when the operation is required:
- The inefficiency of conservative methods of therapy.
- 3 and 4 stages of pathology with inflammation and severe pain.
- Degenerative tissue lesions.
Depending on the stage in which the articular fabric abides, the surgeon-orthopedist selects the type of operation with valgus deformation of 1 finger.
Types of Valgus deformation operations
When the thumbnail of the thumb is diagnosed, the operation is used to exposure 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 - from easy correction and so -called minimally invasive interventions to excision of articular heads and even the entire joint with a replacement for artificial endoprosthesis.In addition to the degree of damage to the plus-phalange of the joint, when choosing the operation of the valgus deformation of the first finger, the general condition of the patient and the presence of other diseases are taken into account.Removal is carried out under local anesthesia or under general venous anesthesia - at the choice of the patient.
McBride
Operation McBride, other names: Silver operation, tendon transposition, refers to minimally invasive interventions affecting only soft tissues. In the process, the surgeon moves the tendon of the removing muscles of the thumb to the head of the I plus bone.Since as a result, the entire muscle-purseline balance of the foot changes, and I and II, the metatarsal bones come closer due to the formation of traction of the dialing muscle, it cannot withstand the overload of the foot, and the relapse of the disease occurs very often.In fact, this operation only temporarily eliminates pain and suspenses the development of deformation.
Seri
Seri osteotomy also refers to sparing interventions, it is short in duration. In the process, the distal cutting of the distal Metaphys of the first plus bone (cones) with further fixation of the bones with a knitting needle, which is inserted through the thumb, is performed. Next, a special boot for the rehabilitation period is assigned.Seri Operation of Valgus deformation of the first finger of the foot, according to the reviews, gives a noticeable result, the postoperative period is short -lived, after you can switch to ordinary shoes.The effect is long, the probability of relapses is low.
Chevron
Chevron or Chevrony V-shaped osteotomy (Chevron Osteotomie) or-a minimally invasive operation used only with small deformations (the angle of displacement of the thumb up to 17 degrees) and without concomitant pathologies (arthritis, arthrosis). In the process, two small cuts are produced, ligaments and joint capsule are shifted, bone corn is removed, then the phalanx is fixed using a titanium wire or 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-RANTGEN.The effectiveness of the operation is high, relapses rarely happen, but due to the complexity of the intervention itself and the requirements of a very high qualification of the surgeon, rarely is used.
Scarf
SCARF osteotomy (scarf, Z-shaped) is used for moderate and severe form of deformation of 1 plus bone of the foot, with an angle of tilt of the finger to 40 degrees. The process is carried out through a cut from below the foot to the base of the plus bone.There, a z-shaped wedge is cut out-and the phalanx head is shifted to the correct 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, since the patient does not experience any discomfort.In surgery, this is the most commonly used operation in the diagnosis of valgus deformation of the thumb of the foot.Reviews talk about rapid healing after surgery, minimum scarves, a short rehabilitation period.The effect is excellent, long -term, relapses are extremely rare.
Arthrodesis with valgus deformation
Arthrodesis or lapidus operation - the closure of the medial joint is used in severe complicated deformations, which are accompanied by especially high joint mobility.This is a radical operation in which complete immobilization of the plus-clinovic joint is performed. To do this, the bones forming it are tightly connected by 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, the deformation is completely eliminated, the manifestations of arthrosis and soreness disappear.The immobility of the joint does not affect the patient’s gait, but it is impossible to wear shoes with heels.Gradually, with the use of drug therapy and physiotherapy, the structure of the joint and foot is completely restored.The results are positive in 98% of cases.According to reviews, the radical valgus deformation of the thumb of the foot with the operation of arthrodesis allows you to restore the functions of the foot even in advanced cases
Finger deformation operation
Apply for various degrees of deformation of 2-5 fingers, depending on this the type of surgical intervention is selected.This can be a closed violent unacceptable elimination of joint contractures and axial deformations of the extremities by stretching and partial rupture of soft tissues, modeling or complete resection of the heads of the metatarsal bones and phalanges, movement (transposition) and crossing (tenotomy) of tendons, shortening of the plus bones with a change in the position and angle of inclination of their heads (osteotomyWilson).The correct position of the fingers is fixed with the knitting needles or screws of Herbert.The desired result for a long time can be achieved in 85% of interventions on curved fingers.The pain and discomfort when wearing shoes decreases or completely disappears.Correction of valgus deformation of the fingers of the foot with operations of this type gives a good cosmetic result.According to statistics, complications are found no more than 2-3% of surgical interventions.The forum dedicated to the valgus deformation of the thumb of the foot is filled with reviews of the effectiveness of operations to remove the cones.
Rehabilitation after surgery
The postoperative period is divided into several periods.Bed rest in the clinic lasts 2-3 days.Already 5-6 hours after the operation, the development of the leg begins - fingers move.From the third day, you need to get up and walk using the special shoes of the barok, and then orthopedic orthosis, which remove the load from the operated joints.With some types of operations (arthrodesis), the time in the hospital can be extended up to 10 days.The second stage is the healing and restoration of the supporting function of the leg.It lasts from 3 to 6 months.At this time, swelling of the foot and ankles may remain.To alleviate the condition, you need to relax with your legs raised.Cool grass compresses are also effective.A 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 healed, water procedures need to be carried out by protecting the leg with a tied plastic bag.Physiotherapists are also prescribed: electrophoresis, shock wave therapy.Massage begins to be used no earlier than a month after surgery, and physiotherapy exercises - after 2 months.Most often this is the development of the foot, an exercise bike, swimming.To support the joint in the correct position, it is necessary to use a hard night valgus tire.In the daytime, orthopedic shoes are worn, the term is at least 3 months.Wearing a heel is allowed no earlier than 6 months after surgery, a height of not more than 4 cm. Sports can also begin only 6 months after elimination of deformation.
Contraindications to the operation
The restrictions in surgical treatment of the bones on the leg are not very extensive:
- Pathologies of the vessels of the limbs - varicose veins 3 and 4 degrees, thrombosis, obliterating 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 the disease is launched.
- The effectiveness of operations is high, complications are rare.
- The sooner you start treatment, the easier the operation and rehabilitation.