The valgus deformation of the leg thumb is so common that in medical practice it can take more than four hundred opportunities to operate the problem.Of course, not all interventions were the same success and completely solved the problem of patients, so in modern practice, the most advanced opportunities for intervention remained, with high chances of recovery.Nowadays, the Khalus valgus operation focuses on the least possible invasion, with the good therapeutic effect of intervention.
Indications
Khalus valgus is a problem not only for adults, but also in children.The formation of the cone on the leg of the thumb does not interfere with patients at the initial stage until there is a sharp pain during walking, problems with the choice of shoes and periodic inflammation of the bone.At this stage, most patients try to relieve pain with folk methods.Various compression and baths only tighten the course of the disease and lead to the only true solution of valgus deformation - surgical intervention.
Signs of the operation:
- Increased pain in the leg thumb;
- chronic inflammation that cannot be stopped, constant swelling;
- skin damage to the curvature of the valgus (cracks, suppression, ulcers);
- Plana valgus foot with the pronounced curvature of the thumb joint;
- the inability of patients with conservative methods;
- the appearance of lame walking;
- Limit motor activity in the foot.
Doctors insist on treating the thumb solely on surgery, as most patients turn around the disease stage when the pathology cannot be corrected in a conservative way.However, if you do not start treating the bones on the legs, this eventually leads to the burden of the other fingers, so the fingers suffer and bow from the second to the fifth.Only timely surgical intervention can avoid such complications.
Preparing for the intervention
During the operation of the Valley deformation of the foot thumb, severe preparation is carried out in orthopedics.The patient performs all the necessary tests.Their key to these is a blood test that results are important to exclude signs of the inflammatory process of the body.
In some cases, a standard list of analyzes can be complemented by determining the levels of oncology hormones and markers if doctors suspect that the foot is a malignant process.
The mandatory stage of orthopedic operations is an X -ray diagnosis -During the study, the images are taken with two projections to determine the nature of the deformation and the severity of the abnormal disorders.
In difficult cases, doctors may require magnetic resonance or computer tomography.Such a study gives more accurate results.According to analysis, doctors decide how to perform the surgery.
Classification of surgical interventions
All the operations that Valgus perform can be divided into two large groups - an invasive operation and reconstruction interventions.The first type of surgical interventions on the foot is characterized by low trauma.
Operations are used limited - only during the early stages of the disease, if the deformation is insignificant and in the case of a benign increase in cartilage, which can be easily removed during surgery.In all other cases, minimally invasive operations do not solve the patient's problems.
Most minimally invasive interventions are carried out quickly and do not provoke complications.Scars after such an operation are minimal.The doctor performs two three -three punches with a length not exceeding 0.5 cm.After these operations, the skin is restored very quickly and the disability is up to two weeks.
Damage to soft tissues during reconstruction procedures is more significant.However, huge extra operations are to promote significant deformation of the legs and severe curvature.The reconstruction intervention reaches up to four centimeters and is located on the medial side of the foot.During such surgery, doctors completely restore the anatomical position of the leg thumb.
You can also consider the operations depending on the location performed.Three groups of interventions are distinguished - soft tissues, bone tissue and combined surgery.When intervention of soft tissues, valgus deformation can only be eliminated if there is no deformation of the extra bone head.In such an intervention, the doctor works only with soft tissues - tendons, muscles, pepper.
Bone tissue surgical intervention can improve the deformation of second and third degrees.The purpose of the intervention is to submit some of the bone or to perform osteotomy.With combined operation, the intervention occurs in both soft tissues and bones.But the possibilities of such surgery are wider - doctors can simultaneously remove bone growth and make ligaments.
Operating techniques
Many operational techniques can be eliminated on the legs, each of which has its own benefits and is selected by certain indications.
McBride
With surgical intervention, McBrard is performed in the first interval, only at the level of the head.With the help of clamps, the doctor spreads soft tissues and prepares the surface insertion ligament.Subsequently, the surgeon gets access to the muscle inaches, which is responsible for the distribution of the first finger - a special seam material - vikril - mobilizes and sewn.
In addition, the Doctor works with Sesam -shaped bones, crossing a deep bundle attached to the sneak -shaped bone, which is eliminated by its subluxation.The plusNefalanx joint capsule is then autopsy on the outer surface, then the incision is made on the inner surface of about 5-6 cm long, the nerve is on it and is directed to the side.
The autopsy of the capsule is performed in the form of the English -language letter and its climax is directed toward the thumb.The bone and below it are removed from the houses from above, and cartilage growth is removed on the head of the metatarsal bone.If this does not happen, in the future, patients will experience pain in the joint.
In the future, the operation will be developed in two ways, depending on the need for osteotomy.In the case of osteotomy, a sound that is secured to the bone fragments should be used.In the final stage, the excess tissue of the capsules is removed, plastic is carried out with certain tissues of the tissues, and the surgeon sews the edges of the wound and processes its surface.
Such a technique was suggested more than eight decades ago, but to date the operation has not lost its relevance.In order to avoid a decline after the intervention, after surgery, patients are recommended to wear special orthopedic shoes.
Seri technique
In 1998, Seri's minimally invasive technique was recommended by surgeon Cesare Faldini.It is now actively used in the surgical practice of doctors in many countries.It refers to low traumatic procedures and is effective in the early stages of the disease and the curvature of the moderate value of the foot, when the angle of the leg thumb does not exceed forty degrees.
REFERENCE!Surgery is not performed because of severe arthrosis.In addition, patients can refuse this type of intervention with the instability of the first metatarsophalangeal joint.
Foot operation is carried out during local anesthesia.The doctor makes an incision in the projection of the plus bone of the thumb, opens the common capsule, and osteotomy performs with a special file or chisel.In such a process, you can reach further redistribution of the load in the distal part of the plus bone.
During surgery, doctors Kirshner are used to create the correct position of the thumb - they start in the medial side of the surface, then the doctor brings finger in hand mode and put it in the right position.During the rehabilitation process, it requires plaster binding - it is used for at least two weeks.Speech removal is carried out after about 1-1.5 months.
Chevron
Chevron technique is used for smaller deformations when the angle is less than 17 degrees.The main prerequisite for the implementation of such an intervention is the lack of arthrosis and other serious changes that are provoked by your feet.
Operational treatment is carried out as follows - in the initial stages, the doctor cut the skin directly with the foot above the flame pack.The abbreviated connections and the joint capsule itself are distinguished.Degenerative changes in tissues and ligaments usually trigger the thumb deformation.The joint bone corn is removed using a chisel or file.
On the metatarsal bone, a cut is made at the head level, shifts from the outside and is mounted under the seasamoid bone.The Phalanx is then secured with screws or wire and the capsule closes.After surgery, the titanium screws do not require removal, but three months after surgery, the wire is eliminated if it does not have to be done before.
Scarf
In most patients, you can remove your leg on the leg using scarf oosteotomy.Such an operation is performed with a moderate deformation of the first finger of the foot.To date, the operation is the most common method of treating valgus, with many benefits to other methods.
Positive aspects of the operation are as follows:
- Not only is it possible to switch, but also rotation of the extra bone head, which allows you to achieve a more progressive result than in other surgical interventions;
- The doctor is able to perform the extension procedure with inadequate value;
- Variation deformation can shift the bone on the medial side;
- Move the bone slightly down and sideways to reduce the inside of the foot and the load on the first finger area;
- If necessary, you can shorten the length of the bone;
- When the joint is pronounced, the bone elements can be rotated.
The surgical intervention is performed during spinal sensation.The surgeon inside the foot cuts from the front of the finger to the front of the metatarsal bone.Subsequently, a zigzag -shaped incision is performed on the side of the front finger, and the bone head is placed in the desired position and the angle changes.However, the doctor changes the location of the tendons that are fixed to the thumb.
Then a deformed joint capsule is separated from the outside and the bones are secured with titanium screws.Usually, the fasteners are not removed if they do not cause discomfort, then the patients are involved.Post -surgery rehabilitation takes three to six weeks.Immediately after the intervention, patients are recommended to wear a special orthosis or tire in which the leg should be filled as soon as possible.The tire is constantly rushing until the recovery period disappears.
Laser intervention
Laser removal of valgus deformation is also possible, but patients should not be given high hope for such a surgical method.Although minimal and gentleest, it is used exclusively in early stages of the formation of the pathological process.
The undoubted advantage of surgical intervention is a small incision that doctors do near the largest point of the bone edge.After healing, such an injury is virtually not noticeable, which allows you to restore the aesthetics of the foot.By using a laser, doctors have the opportunity to perform limited intervention:
- The existing existence - with the help of a laser, is removed part of the cartilage growth, which is formed in the early stages of the valgus;
- Make osteotomy with a large cut - the proximal phalanx of the first finger is removed in the surgery process;
- Perform resection artroplastics - a portion of the plus bone and thumb -phalanx is removed.
The laser is usually removed at clinics where special equipment is.Post -surgery healing is minimal - patients can go normally within a few weeks.
The only disadvantage of the laser intervention is that the incorrect position of the bone is not exposed to correction and increases only under the desired parameters.In this case, patients are threatened with relapses.
Joint control
The operation of the valgus artrodesis is rarely used, but sometimes this is the only way for patients to get rid of the big finger of the foot.The operation belongs to the most radical methods of the intervention.
Such surgery can be used to remove the phalanx base of the first finger of the foot and secure your fingers with special screws.
IMPORTANT! To achieve the main goal during the operation - eliminating deformation and giving the joint position properly, but not all patients will be comfortable after such surgery.
There are serious contraindications to the intervention:
- vascular atherosclerosis and other circulatory disorders;
- Diabetic leg;
- Polyneuropathy.
In arthritis and arthrosis, patients can also refuse surgery if the joints are very deformed, destroyed, and continuously inflamed.In this case, patients advise minimally invasive surgery.
The following pathologies may occur between the complications of surgical intervention due to severe pain due to the bone titanium recording structures.Post -intervention rehabilitation lasts eight weeks.Walking in plaster is only necessary in the first days after surgery - this is needed to record the elements.You can use a baroca boot.This is a specially designed orthopedic shoe that removes the load from the operated leg.
Overview
If the patient has surgery to eliminate the valgus, read reviews and find out what type of intervention is performed and how effective they are.Here are some similar reviews:
"Last year, due to the finger's valgus deformation, I had to finish the ballerina's career. The method was made a scarf, it seems that everything went well, but the foot still hurts at the load."
"I've been suffering for a long time, but I didn't dare to go to surgery.
"The bone on my feet is hereditary - even my mother and grandmother suffered in gout.
In most cases, Valgus deformation operations allow people to solve the bone problem on their finger.When the first signs of the valgus appear, do not postpone treatment - the best result appears in the early stages of the disease.