Surgery of the hallux valgus

Hallux valgus is a common disease that is also known under several other names. Doctors say about hallux valgus and hallux valgus in the foot plan. People who are not related to the medicine, known simply as "the bone" or halus valgus.

hallux valgus treatment operation

Pathology is easy to identify. With the inner part of the foot there is a thickening in the form of corn. Occasionally it hurts, and slowly increases in size. At the same time, the big toe begins to deviate towards the second toe, in advanced cases cross lines with him. Together with the imperfection of aesthetics, there is a serious problem: the inability to use shoes even casual. The following stages of the disease be arthritis and bursitis, the inability of independent movement.

Often the first finger is deformed women prefer to wear high-heel shoes (above 4 cm). In addition, it is an occupational disease of ballerinas. Excess loads are felt immediately, but after a while, when the correction of the situation is difficult.

Surgical treatments

All in all, the surgery to remove halus valgus is divided into minimally invasive and open. Minimally invasive is performed through small incisions in the skin. In most cases, not even need stitches. The recovery is quick and easy.

Open surgical interventions include three categories:

The manipulation of the soft tissues.

Example of cooperation McBride. The dissection of the muscles and ligaments of the foot. The bones are not affected. Intervention effectively to small deformations, can be performed in case of contraindications of the bone-joint system.

Osteotomy.

It is an artificial fracture of the metatarsal bone. The break picks up the doctor. Because of this correct the position of the cane

Arthrodesis.

The surgery is used in advanced stages of hallux valgus, when you need to get physiological shape to the joint.

The doctor, of all the available methods of surgical intervention, select the one that best solves the problems of each patient.

Operation requires advance preparation. You need to get the results of some tests. Among them, clinical and biochemical blood and urine, analysis of blood with the deployed coagulogram, tests for infections, blood-borne pathogens. Appoint electrocardiography, perform x-rays of the foot (necessarily in two dimensions).

If contraindications for surgery to remove halus valgus have not been identified, agreed upon method of anesthesia. Often enough local anesthesia.

hallux valgus surgery treatment indications

Distal osteotomy

The most common surgically correct hallux valgus is distal osteotomy. The operation takes place in several stages:

  1. The first scenario

    Azotobacteria or remove the "bones". In non licet cases, this stage may be the only one. Through a small skin incision or even no incision, endoscopic, removed-is exostosis (bone) and inflammation of a joint capsule.

  2. Second stage.

    Distance osteotomy. With the help of artificial fracture is aligned with the position of the first metatarsal bone. The site of the fracture is held together with screws of titanium. They removed a month later, after the bone is fully fused.

  3. In the third stage.

    Dissection of the muscles responsible for abduction of the thumb.

  4. The fourth and final phase.

    Pinning the big toe in a position of physiological.

Surgical treatment halus valgus: indications

To fix the position of the thumb, conservative methods possible in children, when the bone of the skeleton is still forming. In all other cases, only an operation can help. The main indications are:

  • discomfort when walking, because of the unbearable pain;
  • the deviation of the joint to a few tens of degrees;
  • very bulky of the bone, not giving the possibility to wear shoes;
  • the violation of the position of the feet, which prevents the movement;
  • swelling of the thumb;
  • inflammation and other complications halus valgus.

Directions given by the doctor individually for each patient. Usually surgical methods are used when conservative (conventional methods, without surgery) are not effective.

Contraindications for surgical treatment

Surgical intervention is very effective. Unfortunately, there are a number of contraindications, when it could not proceed:

  • atherosclerosis and other serious diseases of peripheral vessels;
  • foot diabetic (decompensated diabetes mellitus);
  • diseases of the organs of hematopoiesis, coagulation of the blood;
  • innervation and blood supply of the foot of any origin;
  • purulent infection.

Myths about the surgery to remove halus valgus

Among people there are many myths about surgical removal of "bones". Dispel some of them.

You can't do the surgery, if you have arthritis and osteoarthritis. In fact, these diseases are considered to be contraindications related. The operation is possible, only a physician to treat with great care.

It is useless to operate: os will continue to grow. When you efficiently completed the intervention the probability of the re-development of hallux valgus tends to zero. Relapses occur, but very rarely.

It must sit without movement and be in a cast. Modern technologies give the opportunity to move on their own within a couple of hours after the intervention. The bones are united by special structures, so that the need for a cast there.

Possible complications

halus valgus surgical treatment method one of the safest. Complications are extremely rare. Among the negative consequences are:

  • the lack of sensitivity in the fingers of feet because of damage to the nerve fibers;
  • hypersensitivity reactions (allergies);
  • violation of the range of movement of the gold;
  • the adhesion of the infection;
  • deep vein thrombosis;
  • the melting of the metatarsal head.
hallux valgus treatment operation recovery

How to recover after surgery

Very important period of recovery after surgery to remove halus valgus. Is 4-6 months. Detailed instructions on how to behave during the recovery period, gives doctor.

There are common elements of rehabilitation that must be known for all patients.

The first and the second day. The rest in bed. You can move, but it is better not to act. It is recommended to keep the legs elevated and occasionally, if there is pain to move the fingers.

On the third day. You can start to move slowly. It is important to choose a good orthosis and footwear, which after the operation should be special, that has the load of the operated part of the foot. In the majority of cases, used shoes Baruka (French surgeon who invented them), exonerandas the forefoot when walking. In a first moment, to get used, it is possible to provide additional support in the form of sticks or crutches. After three to five days, it would not be necessary.

10-14 days. The period of supervision of phd. In the case of a serious operation all the time the patient can spend in the clinic. We recommend sessions of physical therapy and physiotherapy. Time of stay on your feet, is not desirable.

After 1-1. 5 month there is no need to Orthez, but the shoes, after the operation it is best to use appropriate templates for orthopedic.

After 2 months you can do spin classes and swim in the pool.

Up to three months may continue swelling of the foot and ankle. At this time, it is recommended to use cold compresses, use compression tights.

After 4-6 months, it is possible to walk without an orthosis, to resume playing sports, wear shoes with a heel. The quality of the restoration and faster recovery needed to make a choice in favor of comfortable wide shoes. Don't forget to create an environment that is comfortable for your feet, so that unpleasant situation will not happen again.

11.09.2018