The valgus deformation of the foot foot is so often that in medical practice you can count more than four hundred options for the operational solution of this problem.Of course, not all interventions were the same success and completely solved the patient's problem.In modern practice, the most advanced intervention options remained in which the patient's recovery opportunities are high.Today, the Khalus Valgus surgery focuses on the less possible invasiveness as possible in combination with a good therapeutic effect of the intervention.
Indications
Khalus Valgus is not only a problem for adults, but also in children.The formation of a cone on the leg of the thumb in the early stages only disturbs the patients when a sharp pain occurs while walking, problems with the selection of the shoes, periodic inflammation of the bone.At this stage, most patients try to relieve pain with folk methods.Various compresses and baths only tighten the course of the disease and lead to the only real solution to the valgus deformation - surgical intervention.
Indications for the process are:
- increased pain in the thumb of the foot;
- Chronic inflammation that cannot be stopped constantly swelling;
- Damage of the skin in the Valgus curvature (cracks, supplement, ulcers);
- Plana Valgus foot with a pronounced curvature of the thumb joint;
- the inability to help patients with conservative methods;
- The appearance of a lame;
- Restrict motor activity in the foot.
Doctors insist on the treatment of valgus, the thumb exclusively surgically, since most patients turn to the stage of the disease if it is not possible to conservatively correct the pathology.If you do not start treatment of the bone on the legs at the same time, this ultimately leads to the redistribution of the load on other fingers, which is why the fingers suffer from the second to fifth and bow.Such complications can only be avoided with a timely surgical intervention.
Preparation for the intervention
Serious preparation is carried out in orthopedics while operating for the valgus deformation of the foot of the foot.The patient carries out all the necessary tests.The key of them is a blood test that is important to exclude signs of the inflammatory process in the body.
In some cases, the standard list of analyzes can be supplemented by determining the degree of hormones and markers for oncology if doctors suspect the development of a malignant process in the foot.
An obligatory level in orthopedic operations is an X beam diagnosis.During the study, pictures are taken into two projections to determine the type of deformation and severe pathological disorders.
In difficult cases, doctors can fall back on magnetic resonance or computer tomography.Such a study provides more precise results.According to analyzes, the doctors decide how best to carry out the operation.
Classification of surgical interventions
All operations carried out by Valgus can be divided into two large groups - invasive operation and reconstructive interventions.The first type of surgical interventions on the foot is characterized by low trauma.
Operations are only used to a limited extent - only in the early stages of the development of the disease if the deformation is insignificant and in the presence of a benign growth of cartilage, which is easy to remove by the operation.In all other cases, minimally invasive operations do not solve the patient's problems.
Most minimally invasive interventions are carried out quickly and do not provoke complications.Scars after such an operation are minimal.The doctor does two to three punctures, the length of which does not exceed 0.5 cm.After these operations, the skin is restored very quickly, and the working hours of the work is up to two weeks.
In the case of reconstructive interventions, the volume of damage to the soft tissue is significant.However, a big plus of operations is that they themselves remove a significant deformation of the legs and help with severe curvature.The incision in reconstructive intervention reaches up to four centimeters, it is located on the media side of the foot.During such an operation, doctors completely restore the anatomical position of the foot tree.
You can also consider the processes, depending on the location where you are carried out.Three groups of interventions are differentiated - on soft tissues, on bone tissue and combined operation.When carrying out interventions for soft fabrics, it is possible to eliminate the valgus deformation only if the head of the plus bone is not deformed.In the course of such an intervention, the doctor works exclusively with soft parts - tendons, muscles, borsen.
With surgical interference in the bone tissue, it is possible to correct the deformation of the second and third degree.The intervention is to submit part of the bone or to guide osteotomy.With a combined operation, the intervention occurs in both soft tissues and bones.However, the possibilities of such an operation are wider - doctors can at the same time remove bone growth and produce ligaments.
Operation techniques
Several operating techniques can be removed on the legs, each of which has its own advantages and is selected with certain information.
Operation McBride
In the event of surgical intervention, McBraid is carried out in the first interval of the heads in the first Inter -Flood interval.With brackets, the doctor spreads soft fabrics and exhibits the inter -flood band on the surface.After that, the surgeon gains access to the tendon of the muscle, which is responsible for the assignment of the first finger - it is mobilized and sewn by a special seam material - Vikril.
In addition, the doctor works with sesame -defined bones, he crosses a deep bundle that is attached to the bone packed by sesame, which is eliminated by its subluxation.Then the capsule of the Plusnephalanx joint is broken down on the outer surface, according to which the incision on the inner surface of the foot is about 5 to 6 cm long, which is released by it and redirected to the side.
The capsule is dissected in the form of the English letter V and its summit is pointed on the thumb.The hooks of the homemer are removed from above above the bone and below it, the cartilage growth on the head of the midfoot leg is removed.If this is not done, patients will have pain in the future.
In the future, the development of the company can take place in two types, depending on the need for an osteotomy.In the case of osteotomy, there is a need to use a spoke that connects the tendon to bone fragments.In the last stage, excess tissues of the capsules are removed, plastic is carried out with a certain voltage of the tissue, whereupon the surgeon sews the wound edges and processes its surface.
Such a technology was proposed more than eight decades ago, but the operation has not yet lost its relevance.So that there is no relapse after the operation after the intervention, patients are recommended to wear special orthopedic shoes.
Seri technology
The operational technology for the minimally invasive technology from Seri was proposed in 1998 by surgeon Cesare Faldini.Now it is also actively used in the surgical practice of doctors by many countries.It refers to low -traumatic processes and is effective in the initial phase of the development of the disease and with a moderate valgus curvature of the foot if the deviation angle of the footbage does not exceed more than forty degrees.
REFERENCE!The operation is not carried out due to severe osteoarthritis.In addition, patients can reject this type of intervention with the instability of the first metatarsophalangeal joint.
The operation on the foot is carried out under local anesthesia.The doctor makes a cut in the projection of the head of the plus bone of the thumb, opens the joint capsule and carries out an osteotomy with a special file or a chisel.With such a procedure, you can achieve a further redistribution of the load in the distal part of the plus bone.
During the operation, doctors use Kirshner's knitting needle to create the correct position of the thumb.They start in the spitting direction in the medial side of the surface.Then the doctor brings a finger into manual mode and puts it in the right position.The operation in the rehabilitation process requires wearing a plaster dressing - it is used for at least two weeks.The spoke is removed after about 1-1.5 months.
Chevron technology
The Chevron technology is used for minor deformations if the angle is less than 17 degrees.The main condition for the implementation of such an intervention is the lack of osteoarthritis and other serious changes that provoke the valgus of the foot.
The company treatment is carried out as follows - in the initial stage, the doctor cuts the skin directly above the fucked foot.Shorted connections and the joint capsule itself are distinguished.Degenerative changes in the tissues and ligaments usually carry out a deformation of the thumb.Bone corn on the joint is removed with a chisel or a file.
A cut is carried out on the midfoot bone at head height, shifting on the outside and installed under the sesamoid bone.Then the phalanx is attached with the help of screws or wire and the capsule closes.After operation, titanium screws do not have to be removed, but they eliminate the wire three months after the operation if this is not necessary earlier.
Formwork technology
In most patients you can remove the bone with a Schaloostomie on the leg.Such an operation is carried out with a moderate valgus deformation of the first foot finger.So far, the company is the most universal method for treating valgus, it has many advantages compared to other methods.
The positive aspects of the operation are as follows:
- It is not only possible to move, but also to turn the head of the plus bone, which enables them to achieve a more progressive result than in other surgical interventions.
- The doctor can carry out the extension procedure with an inadequate value.
- With variant formation you can move the bone in the medial side.
- To reduce the load on the inner part of the foot and the first finger area, you can move the bone down and to the side a little.
- If necessary, you can shorten the length of the bone;
- Bone elements can be turned when the joint is pronounced.
The surgical intervention takes place under vertebral anesthesia.The surgeon on the inside of the foot makes an average from the beginning of the finger to the beginning of the midfoot leg.Then an incision is produced in the bone of the first finger on the bone of the first finger, whereupon the bone head is moved to the desired position, and its angle changes.At the same time, the doctor changes the location of the tendons that are attached to the thumb.
A deformed joint capsule is then separated from the outside and the bones are fixed in the required position using titanium screws.Fastening elements are usually not removed if they do not have any symptoms, then the patients and then with screws.Rehabilitation after the operation takes three to six weeks.Immediately after the intervention, it is recommended to wear a special orthosis or a tire in which it is necessary to load your foot as early as possible.The tire hurries all the time while the recreation period passes.
Laser intervention
The removal of the valgus deformation with a laser is also possible.However, patients should not hope for such an operation method to a large extent.Although it is minimal and gentle, it is only used in the early stage of the development of the pathological process.
An undoubtedly advantage of a surgical intervention is a small cut in size that doctors earn near the largest point in the bone set.After healing, such an injury is practically not noticeable, so that you can restore the aesthetics of the foot as far as possible.With the use of a laser, doctors have the opportunity to carry out limited interventions:
- The existectomy is carried out - with the help of a laser, part of the cartilaginous growth is removed, which is formed in the early stage of Valgus.
- Make osteotomy with a large cut - the proximal phalanx of the first finger is removed in the operating process;
- Cover resection arthroplasty - the articular surfaces of the plus bone and the part of the thumb phalanx are removed.
The removal of the lasers is usually carried out in clinics in which special equipment is available.The recovery after the operation is minimal - patients can run normally in a few weeks.
The only disadvantage of laser intervention is that the wrong position of the bone is not subject to correction and only grows under the desired parameters.In this case, patients are threatened with relapses.
Arthrodesis
Operation to remove valgus by arthrodesis is used quite rarely, but sometimes this is the only way for patients to get rid of the big foot finger.The operation is one of the most radical intervention methods.
With the help of such an operation, it is possible to remove the base of the phalanx of the first foot finger and to fix the fingers with special screws.
IMPORTANT! During the operation, the main goal is reached - to eliminate the deformation and give the joint the right position, but not all patients conveniently after such an operation.
There are serious interventions:
- Vascular atherosclerosis and other circulatory disorders;
- Diabetic;
- Polyneuropathy.
In arthritis and arthrosis, patients can also reject surgery if the joints are very deformed, destroyed and constantly inflamed.In this case, patients advise a minimally invasive operation.
Under the complications of surgical intervention, the following pathologies can occur painful pain due to the titanium mounting structures installed in the bone.Rehabilitation after the intervention takes eight weeks.A plaster is only necessary in the first days after the operation - this is necessary to fix the elements.You can use a Baroka boot.This is a specially developed orthopedic shoes that removes the load from the leg.
Reviews
If the patient has an operation to eliminate valgus, he can read and find out evaluations which types of interventions are carried out and how effective they are.Here are some similar opinions:
"Last year I had to end the ballerina's career due to the valgus deformation of the finger. They made a scarf according to the method, it seems that everything went well, but the leg still hurts when loading."
"I have suffered for a long time, but I didn't dare to go to the operation. I was made a complex arthrodesis, the restoration lasted more than two and a half months, but after the operation it was much easier. Now I can go without hell and have no pain."
"The bone on my leg is hereditary - even my mother and grandmother suffered from gout. I decided to do the operation as soon as the first signs have appeared. The operation used a laser, all additional growth has been removed for me, now the leg has a normal look, but the doctors said they should follow possible relapses."
Valgus deformation operations In most cases, a person enables a person to solve the problem of the bone on the finger.If the first signs of valgus occur, the treatment do not shift - the best results occur in the early stage of the development of the disease.