Surgery for hallux valgus

Hallux valgus is a common disease that is also known under several other names. Doctors say about the hallux valgus and hallux valgus flat feet. People who are not connected with medicine, is referred to simply as "bones" or halus valgus.

hallux valgus treatment

The pathology is difficult to determine. With the inner part of the foot is a thickening in the form of maize. Occasionally it hurts, and gradually increases in size. At the same time the big toe starts to deviate towards the second finger, in more extreme cases, the cross lines with him. Along with the aesthetic disadvantages, there is a serious problem: the inability to use, the shoes also sports. In the following stages of the disease can be arthritis and bursitis, loss of capacity for independent movement.

Often the first finger is deformed women prefer to wear high heel shoes (above 4 cm). In addition, the occupational disease of the ballerinas. Excessive loads are felt immediately, but after some time when correcting the situation is difficult.

Surgical treatment

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

Open surgical interventions include three categories:

Manipulation of the soft tissues.

Example — the operation of McBride. Analysing the muscles and ligaments of the foot. The bones are not affected. Intervention effective at small deformation, can be performed in case of contraindications to bone-joint system.

Osteotomy.

The artificial fracture of the metatarsal bones. The Break up doctor. Because of this to fix the situation.....

Arthrodesis.

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

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

The operation requires advance preparation. You need to get the results of some tests. Among them, clinical and biochemical blood and urine tests, blood tests, posted coagulogram, tests for infection, blood-transmitted pathogens. Called electrocardiography, conduct, 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 treatment indications for surgery

Distal osteotomy

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

  1. In the first instance,

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

  2. In the second phase.

    Remote osteotomy. With the help of the artificial fracture is aligned with the position of the first metatarsal bone. Place the breakout is held together with screws from titanium. They will be 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 stage.

    Laying the thumb in the physiological position.

Surgical treatment halus valgus: indications

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

  • of discomfort while walking, because of the unbearable pain;
  • deviations from the joint for a few tens of degrees;
  • a lot of bulging bone, it does not give the option to wear shoes;
  • violation of the position of the feet, which hamper movement;
  • swelling of the thumb;
  • inflammation and other complications halus valgus.

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

Contra-indications for surgical treatment

Surgical intervention is very effective. Unfortunately, there are several contraindications when you would not continue:

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

Myths about surgery for the removal of halus valgus

Between people there are a lot of myths about the surgical removal of the "bones". Remove some of them.

Can't do surgery if you have arthritis and osteoarthritis. In fact, these diseases are considered as relative contra-indications. Operation is only possible the doctor will treat you with great care.

It is useless for the functioning of: bones, will still grow. When you effectively completed the intervention the probability of the re-development of hallux valgus tends to zero. Relapses occur, but very rarely.

Will need to sit without movement and in the cast. Modern technologies give the opportunity to move on their own in a few hours after the procedure. The bones are held together by special structure, therefore the need for a cast there.

Possible complications

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

  • numbness in the legs due to damage to the nerve fibers;
  • hypersensitivity reactions (allergies);
  • violation of the range of motion of the thumb;
  • the approach of the infection;
  • deep vein thrombosis;
  • the melting of the metatarsal head.
hallux valgus treatment operation recovery

How to recover after surgery

A very important period of recovery after surgery for the removal of halus valgus. He is 4-6 months. Detailed instructions on how to behave in the recovery period, giving the doctor.

There are common elements of rehabilitation, which should be known by all the patients.

The first and second day. Bed rest. You can move, but it is better to do the work. It is recommended that the leg elevated and occasionally, if there is no pain to move my fingers.

On the third day. You can start slowly. It is important to select a convenient orthosis and shoes, which after the operation should be special, that takes the load of the operated part of the foot. In most cases, used shoes Baruka (the French surgeon who invented them), exonerandas of the feet when walking. The first is used for the extraction, it is possible to provide additional support in the form of sticks or crutches. After three to five days, that it would not longer be required.

10-14 days. The period of doctoral supervision. In the case of a serious operation the whole time the patient can spend in the hospital. Recommended sessions of physical therapy and physiotherapy. Long stay on the feet are not desirable.

After 1-1. 5 month there is no need to Orthez, but the shoes after the surgery it is better to use with the suitable orthopaedic insoles.

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

Up to three months, you can continue to reduces swelling of the foot and ankle. In the meantime, it is recommended to use cool compresses, wear compression socks.

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

11.09.2018