Surgery percutaneous and other methods of correction of hallux valgus

The term hallux valgus deformity represent the deformation of the joints of the metatarsal/phalanges of the first finger of the foot that is manifested by the inclination of the latter in the direction of the rest of the fingers, such as at least 8°. The first finger (thumb) is offset from its normal position and deflected in the direction of the rest of the fingers, sometimes even superimposed on a second and even a third finger.

The problem is intense pain and concentrated on the single, which in many cases can seriously affect to the foot. And in addition, the deformation of the joint to deteriorate with time and can reach to such a level that the use of the standard shoes becomes a problem.

The surgical intervention was the only treatment in advanced stage

The methods that can be performed the operation, and, of course, the choice depends on the patient characteristics and the reasons for the development of the disease.

nalogenie-shvov-na-stopu

The choice of surgical technique is influenced by the following parameters:

  • The age of the patient. The younger patients recover faster and more completely.
  • The physical condition of the patient. The evaluation is necessary to select the type of anesthesia.
  • The scope of activities and the expectations of the patient about the restoration of the functionality of the feet.
  • Size of the degradation of bones, joints and soft tissues: tendons, cartilage, joint capsules.

It is clear that for the evaluation the doctor will also be based on a series of clinical studies: General medical exam, cardiac testing, blood analysis. There will be some local tests, such as x-rays of the feet, to evaluate the degree of deformation. And it still needs the opinion of the anesthesiologist to select anesthetic.

Anatomy of the thumb

The fingers are made up of segments of bones, phalanges, usually 3 for each finger: phalanx proximal medialis phalanx, and the phalanx distal. The thumb consists of two phalanges: proximal and distal (not enough medial).

The goal of the operation is the result

The surgical intervention for the treatment of hallux valgus aims to:

  • "Restructuring" of the big toe with the metatarsal bone and, in consequence, the reduction of the valgus angle.
  • The decrease of the angle between the first and second metatarsal bones.
  • The restoration of the whole of the function.
  • Elimination of bumps and calluses that are formed on the side of the head of the first metatarsal bone.

Methods of intervention – open surgery and percutaneous

Traditional surgery

As a general rule, the traditional surgical approach in the treatment of hallux valgus is not used in very young patients or in patients with pronounced disorders of the joints.

In this surgery to make incisions large enough to allow access to the surgeon.

Rules of operation:

  • Osteotomy (resection) of the head of metatarsal bones in the most appropriate way (L-, V -, dovetail, etc.) in order to get the best alignment of the phalanx.
  • Osteotomy of the phalanx to complete the alignment.
  • Release the sesamoid bones of any adhesions.
  • The return of the tendon of the adductor muscles of the thumb.
  • The return of the joint capsule and its consolidation with the shortening of the fabric.
  • Insert one or more needles, if necessary, to give stability.

If the affected joint has arthrotic degeneration, during the operation, the surgeon will evaluate the state of cartilage. If possible, the liberation of the articulation of any osteophytes'. Otherwise, it will be recorded so that circulation was possible, despite the stiffness.

Mini-minimally invasive surgery

This form of intervention is very fast (a few minutes, maximum 10), which, obviously, requires less recovery time after the surgery. Its disadvantage is that the doctor has more discretion and can not affect the surrounding soft tissue.

operaciya-hallux-valgus

For this reason, this kind of interference is only indicated for young or very young patients, because they have a high potential for recovery.

Surgery percutaneous

The procedure is similar to the previous one, but in miniature surgical instruments controlled from outside, under the control through x-ray.

This type of operation allows us to intervene also in the soft tissue. Also, of course, in this case, it is important to the skill of the surgeon. However, it is clear that the risk of this operation are very low, but not null. Recovery also happens very fast.

Anesthesia and postoperative recovery

All the described operations are performed under local anesthesia. Mini-invasive and percutaneous interventions are performed in an outpatient setting with a return home in a couple of hours.

Regardless of the method, it is very important to proper recovery after the surgery, which starts immediately after the surgery with the help of special exercises for rehabilitation, which make use of special shoes that allows the patient to walk the next day after the surgery.

07.08.2018