Surgery for hallux valgus

Hallux valgus is a common disease that is also known under several other names. Doctors say about hallux valgus and hallux valgus flat feet. People who are not related to medicine, referred to simply as "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 gradually increases in size. At the same time the big toe starts to deviate towards the second finger, in advanced cases cross lines with him. Along with the aesthetic imperfection, 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. Excessive loads are felt immediately, but after a while, when correcting the situation is difficult.

Surgical treatments

All in all, surgery to remove halus valgus are divided into minimally invasive and open. Minimally invasive are 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 soft tissues.

Example — operation McBride. Dissect the muscles and ligaments of the foot. Bones are not affected. Intervention effectively at small deformations, can be performed in case of contraindications of the bone-joint system.

Osteotomy.

Is an artificial fracture of the metatarsal bone. The break picks up the doctor. Due to this corrected position of the shank

Arthrodesis.

Surgery is used in advanced stages of hallux valgus, when you need to get physiologic shape to the joint.

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

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

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

hallux valgus treatment surgery indications

Distal osteotomy

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

  1. The first stage

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

  2. Second stage.

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

  3. The third stage.

    Dissection of the muscles responsible for abduction of the thumb.

  4. The fourth and final phase.

    Pinning the big toe in physiologic position.

Surgical treatment halus valgus: indications

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

  • discomfort when walking, due to the unbearable pain;
  • the deviation of the joint for a few tens of degrees;
  • much bulging bone, not giving the possibility to wear shoes;
  • violation of the position of the feet, hindering movement;
  • swelling of the thumb;
  • inflammations and other complications halus valgus.

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

Contraindications to 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;
  • diabetic foot (decompensated diabetes mellitus);
  • diseases of the organs of hematopoiesis, blood clotting;
  • innervation and blood supply of the foot of any origin;
  • purulent infection.

Myths about surgery to remove halus valgus

Among people there are many myths concerning surgical elimination of "bones". Dispel some of them.

Can't do the surgery, if you have arthritis and osteoarthritis. In fact, these diseases are considered relative contraindications. Operation is possible just a doctor will treat you with great attention.

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

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

Possible complications

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

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

How to recover after surgery

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

There are common elements of rehabilitation that should be known by all patients.

The first and second day. Bed rest. You can move, but it is better not to act. It is recommended to keep the leg elevated and occasionally, if there is no pain to move my fingers.

The third day. Can start to move slowly. It is important to choose a convenient orthosis and shoes, which after the operation should be special, which takes the load of the operated part of the foot. In most cases, used shoes Baruka (French surgeon who invented them), exonerandas the forefoot when walking. At first, getting used to, it is possible to provide additional support in the form of canes or crutches. After three to five days, they would no longer be needed.

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

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

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 cool compresses, wear compression stockings.

After 4-6 months it is possible to walk without an orthosis, to resume playing sports, wear shoes with a heel. Quality restoration and faster recovery required to make a choice in favor of 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