The normal position of the legs corresponds to an imaginary line drawn through the first gap between the toes, mid knee and hip joint. The deviation of this line is considered as a strain (a violation of the normal arrangement, the curvature), which can be varus and valgus. When varus deformation (Or shape) of the middle part of the tibia is diverted towards the outside, visually, with hallux valgus (X-shaped), the tibia is displaced towards the inside of the legs resemble the letter H.
Valgus deformity of the neck femoral is characterized by changes cervico-diaphyseal angle, increased. Often combined with valgus deformity of legs, and a flat-valgus deformity of the foot. In the majority of cases, this disorder is a pathology congenital due to dysplasia of the hip , but can also develop as a result of the injury or injuries of the nervous system. Can lead to the development of osteoarthritis (damage to the hip joint).
The deviation of the axis of the leg in which persons determined by the distance between the inner ankles about 5 cm, the knees are affected. Hallux valgus feet appear in childhood, due to the premature allow the baby to stand, long stay in position (in the arena), violations of crawl. This is due to the insufficiency of the force of muscles and ligaments, and increased stress. The following are important causes of this disease include rickets , dysplasia of hip, knee injuries. The main changes affect initially the knee joints, there is some overextension them, the appearance of PLANO-valgus flat feet. The child complains of tired feet, asking at the hands, notes the pain in the legs after long walks. Under asymmetric curvature of the legs there is a risk of development of scoliosis (curvature of the spine).
Valgus deformity of the ankle joint is characterized by the displacement of the cancellation of the heel outwards and the foot inwards. Often leads to the development of PLANO-valgus flat feet.
PLANO-valgus deformity of the foot (flat feet) is the most common type of hallux valgus. It is characterized by a change in the direction of the axis of the foot, and a decrease in its vaults. This files most often occurs in childhood. The main reasons:
When valgus deformity of the big toe to the modification of the metatarsophalangeal joint, causing the big toe moves towards the inside. This also alters the position of the other fingers.
Among the causes of hallux valgus of the big toe:
In this pathology, the weakness of the ligamentous and muscular apparatus of the foot. The deformation and osteoarthritis of the joint of the first finger causes increased and uneven stress on the forefoot, which is aggravated by wearing shoes with a narrow nose and/or high heel.
Manifestations of this disease are the appearance of "bones" in altered joint, the change of the position and shape of the other fingers of the foot. This is accompanied by joint pain and foot tiredness of the legs. In the field of "bumps" redness, small swelling .The severity of deformation:1. Deviation of the thumb outwards up to 15 or more .2. Deviation of the thumb 15 to 20 or .3. Deviation of the thumb of 20 to 30 or .4. Deviation of the thumb more than 30 or' .3 and 4 of the degree of deformation can develop complications, such as:
The curvature of the finger is preceded by the discomfort of wearing shoes and pain on walking. Due to the deformation of the joint changes of the foot, the appearance of the elevation in the middle, where easily form painful calluses and corns. Second toe also changes, takes the form of a hammer, also it formed a callus. Similar symptoms, can also occur in other diseases: deforming arthrosis , arthritis, gout . To find out the cause of the "bumps" and pain, you must seek the advice of a podiatrist . After the exam, the doctor will prescribe x-ray examination (picture of the foot in three planes) and planotography. As a result of the development of the pathological process is not about hallux valgus, many patients develop chronic bursitis (inflammation of periarticular bag), and the disease Deutchlander (changing the structure of the metatarsus).
Treatment of flatfoot is a long and laborious process. You must wear shoes orthopedic with a hard heel, special templates orthopedic (preferably custom), the holding of regular sessions of massage and medical gymnastics.
Conservative treatmentnon-surgical methods To treat hallux valgus include wearing orthotic insoles and night buses, templates, finger pads, physiotherapy, exercises and therapeutic for the toes and foot. To reduce inflammation used intra-joint administration diprospan , hydrocortisone (hormonal drugs). Conservative treatment does not lead to complete recovery, is used only in the early stages, and as a preparation preoperative. Surgical treatmentThere are a large number (over 100) and methods of surgical treatment of hallux valgus. The main are listed below:
Keep in mind, however, that the proportion of patients developing a second formation of "bone". In the postoperative period, the patients are forced for a long period of time to limit the physical strain on the foot. This causes some discomfort. Currently we use less traumatic methods of surgical treatment of hallux valgus, which reduces considerably the postoperative period.
On the second day after the surgery, you are only allowed to move the fingers. Walking without stepping on the operated area, it is possible that in 10 days. The load on the foot can only be given after a month after the treatment. Six months later, in a safe postoperative period allows you to exercise with the load on the legs, and wear shoes with heels. An effective method to facilitate the rehabilitation after a surgical treatment of hallux valgus is considered shock wave therapy, which aims to improve the blood circulation in the tissues and decrease the inflammation and pain at the site of the operation.
When valgus deformity of the first finger of the foot, footwear should be soft, with a wide toe and heel low (less than 4 cm). With PLANO-valgus deformity of the foot, you must wear new shoes, high and hard back cover, 3 cm above the heels, with a dense and high instep.
For the correction of the deformity, various types of templates and a half of wax. More suitable for in this custom templates. With its help reduces the load on the joints of the feet, improve the blood circulation of foot decreases the feeling of tiredness in the legs. Templates are sometimes difficult to fit in shoes, especially standard. Therefore, with the purpose of correction of pathological disorders in the foot, you can use the half-wool - cropped version of the conventional template (not the previous). In some mild cases, the podiatrist may authorize the use of orthopedic horseshoes.
1. Massage course is from 10 to 20 treatments, with an interval of approximately 1 month. Massage affects not only the leg and the foot but also your back and hips, so it is important that the state of the whole muscular system participating in the movement. 2. We must start with the lumbar region. Movement - stroking and rubbing from the centre to the outside. 3. Then, you can go to the area of the buttocks that uses a circular stroking, rubbing and kneading, effleurage and stroking. 4. In the back of the thigh to produce intense rubbing from the knee up to the thigh, cut and caresses. 5. Lower leg massage should be different from the inner and outer surfaces. All of the techniques (rubbing, kneading) can be carried out intensively inside and outside gently. This allows you to stimulate the internal muscles and relax the exterior, which leads to the correct foot position.
Hallux valgus in children is mainly represented PLANO-valgus flat feet. In this case there is a deviation heels outwards, causing pain during prolonged walking and increased fatigue. When the time started and regular treatment to achieve full recovery of the foot. To establish the extent of the infringement and the determination of methods of treatment it is necessary to consult a podiatrist.
For the treatment of hallux valgus of the feet of the child should pay attention to posture a little patient: in one position the feet must be worn - this reduces stress on the joints and foot. The duration of the walks should be limited. Affect the installation of the legs:
To correct the installation of the legs should be to wear shoes orthopedic with a high rigid heel or template. The right to collect will help the podiatrist. The shoes should feel comfortable on the foot. Do not wear the footwear used. At home you can walk without shoes. Massage is the best effect in the healing process. Keep it should be regular courses. A very important and therapeutic exercises, exercises should be performed daily. It is best to submit a game for a child made them. Of the exercises, it should be noted the lifting of small items, and the crumpling of the towels with my toes, rolling sticks foot, get out of the position in Turkish. The inefficiency of the treatment resort to surgery. For this purpose, conduct varising the osteotomy. During the operation of the bone (hallux valgus of the tibia is to the femur) cut a wedge. Bone connects with the screws. After the surgery uses the apparatus for the fixation of the exterior of the bone, the osteosynthesis according to Ilizarov. Before the application should consult with a specialist.