In the article, we discuss the functioning of the deformation of the first finger of the foot, indications and contraindications for its implementation.You will discover what types of surgical elimination of bone exist, how is rehabilitation, what complications are possible.The operation of the deformation of the first finger of the foot.Indications for the operation of Valgo deformation.The disease called Valgo deformation is familiar to many: this is the formation of a bulky bone in the thumb of the foot.In addition to the lack of aesthetic attraction, this pathology brings considerable suffering, is dangerous due to the development of irreversible changes in the first plus-phalang of the foot of the foot until its complete destruction.
In the early stages of development in treatment, conservative methods are used: orthopedic correlators in combination with bathrooms and ointments. If such therapy does not provide a result, a person with Valgo deformation prescribes an operation of the deformation of the thumb. Its type depends on the degree of development of the disease, the age of the patient and the presence of other general and local diseases, as well as the causes that caused degenerative changes in the joint.Indications when the operation is required:
- The inefficiency of conservative therapy methods.
- 3 and 4 stages of pathology with severe inflammation and pain.
- Degenerative tissue injuries.
Depending on the stage in which the articular fabric remains, the surgeon-organist selects the type of operation with 1 finger valgo deformation.
Types of Valgo Deformation Operations
When the thumb is diagnosed, the operation is used for exposure only in soft tissues and tendons, to correct a defect in bone tissues or with a combined effect.In total, there are more than 3,000 types of surgical elimination of the bone, from an easy correction and, therefore, minimally invasive interventions are calculated to the split of joint heads and even the entire joint with a replacement of artificial endoprothesis.In addition to the degree of damage to the articulation plant, when choosing the functioning of the deformation of the first finger, the general condition of the patient and the presence of other diseases are taken into account.The elimination is carried out under local anesthesia or under general venous anesthesia, to the patient's choice.
McBride
McBride Operation, other names: silver operation, tendon transposition, refers to minimally invasive interventions that only affect soft tissues. In the process, the surgeon moves the tendon of the thumb extraction muscles at the head of the bone and plus bone.Since as a result, the entire balance of the muscular line of the foot changes, and I and II, the metatarsal bones are approaching due to the formation of the tensile of the marked muscle, cannot support the overload of the foot and the relapse of the disease occurs very often.In fact, this operation only temporarily eliminates pain and suspense the development of deformation.
Seri
Seri's osteotomy also refers to savings interventions, is short. In the process, the distal cutting of the distal metaphys of the first bone (cones) is performed with more fixation of the bones with a knitting needle, which is inserted through the thumb. Next, a special boot is assigned for the rehabilitation period.The seri operation of the deformation of the first finger of the foot, according to the reviews, offers a remarkable result, the postoperative period is brief housing, after it can change to common shoes.The effect is long, the probability of relapses is low.
Chevron
Chevron or Chevrony (Chevron Osteotomie) or a minimally invasive operation used only with small deformations (the thumb displacement angle up to 17 degrees) and without concomitant pathologies (arthritis, osteoarthritis). In the process, two small cuts are produced, the ligaments and the articulation capsule are moved, bone corn is removed, then the phalanx is fixed using a titanium wire or a titanium screw. If necessary, the cable or screw are removed after 3 months.The entire operation is carried out under the control of the EOP-Arontgen.The effectiveness of the operation is high, relapses rarely occur, but due to the complexity of the intervention itself and the requirements of a very high rating of the surgeon, they are rarely used.
Scarf
The osteotomy of the scarf (scarf, in the form of z) is used for a moderate and severe form of 1 more foot bone, with an angle of inclination of the finger at 40 degrees. The process is carried out through a cut from under foot to the base of the bone more.There, a z -shaped wedge is cut and Falange's head moves to the correct position.At the same time, the position of the tendons and the capsule of the joint is replaced. This position is fixed with two miniature titanium screws.In most cases, they are not extracted, since the patient does not experience any discomfort.In surgery, this is the most used operation in the deformation diagnosis of the thumb of the foot.The reviews talk about rapid healing after surgery, minimal scarves, a short rehabilitation period.The effect is excellent, in the long term, relapses are extremely rare.
Valgo deformation arthrodesis
Operation of arthrodesis or lapidus: The closure of the medial joint is used in severe complicated deformations, which are accompanied by especially high joint mobility.This is a radical operation in which the complete immobilization of the most clinovic joint is performed. To do this, the bones that form it are closely connected by 2 titanium screws in a special way in a longitudinal position. This complex operation is used only if other species cannot give a positive result.After arthrodesis, deformation is completely eliminated, manifestations of osteoarthritis and pain disappear.The immobility of the joint does not affect the patient's march, but it is impossible to wear shoes with heels.Gradually, with the use of pharmacological and physiotherapy therapy, the structure of the joint and the foot is completely restored.The results are positive in 98% of cases.According to reviews, the radical deformation of the thumb of the foot with the operation of arthrodesis allows you to restore foot functions even in advanced cases
Finger deformation operation
Request several degrees of deformation of 2-5 fingers, depending on this it is selectedThe type of surgical intervention.This can be an unacceptable violent elimination closed from joint contractures and axial deformations of the limbs through stretching and partial rupture of soft tissues, modeling or complete resection of the heads of the metatarsal bones and phalanges, mudence (transposition) and crossing (tenotomy) of tendons, shortening of the bones more with a change in the position and angle of its inclinationheads (osoeotomy) of tendons, shortening, shortening of the bones more with a change in the position and angle of inclination of their heads (osoeotomy) of the tendons.The correct position of the fingers is fixed with the knit needles or Herbert's screws.The desired result can be achieved in 85% of curved fingers for a long time.Pain and discomfort when wearing shoes decrease or disappear completely.The correction of the deformation of the fingers of the foot with operations of this type gives a good cosmetic result.According to statistics, complications are not more than 2-3% of surgical interventions.The forum dedicated to the deformation of the thumb of the foot is full of reviews of the effectiveness of the operations to eliminate the cones.
Rehabilitation after surgery
The postoperative period is divided into several periods.The break in bed at the Clinic lasts 2-3 days.Already 5-6 hours after the operation, the leg development begins: the fingers move.From the third day, you must get up and walk using the special shoes of the Barok, and then the orthopedic orthosis, which eliminate the load of the operated joints.With some types of operations (arthrodesis), time in the hospital can be extended up to 10 days.The second stage is the healing and restoration of the leg support function.Last 3 to 6 months.At this time, you can remain swelling of the foot and the ankles.To relieve the condition, you must relax with high legs.Cold grass compresses are also effective.One month: two, on the recommendation of a doctor, you will have to walk with crutches so that the articulation does not suffer the load.Until the seams are healed, water procedures must be carried out protecting the leg with a plastic bag tied.Physiotherapists are also prescribed: electrophoresis, shock wave therapy.The massage begins to be used not before a month after surgery, and physiotherapy exercises, after 2 months.Most of the time this is the development of the foot, an exercise bicycle, swimming.To support the Board in the correct position, it is necessary to use a night valge tire.During the day, orthopedic shoes are used, the term is at least 3 months.Using a heel is allowed not before 6 months after surgery, a height of no more than 4 cm.Sports can also begin only 6 months after deformation elimination.
Contraindications to the operation
The restrictions on the surgical treatment of bones in the leg are not very extensive:
- Pathologies of the vessels of the extremities - varicose veins 3 and 4 degrees, thrombosis, erasing atherosclerosis;
- Diabetic foot;
- oncology;
- Purulent infections and acute inflammation.
To remember
- With the bones on the legs, the operation is prescribed whether conservative methods do not help or throw the disease.
- The effectiveness of operations is high, complications are rare.
- The sooner the treatment begins, the easier the operation and rehabilitation will be.