Valgus deformation of the thumb feet is so common that you can count more than four hundred options for the operating solution to this problem in medical practice.Of course, all interventions were the same success and fully solved the problem of patients, so that in modern practice, the most precious opportunities for intervention remained, in which patients recovery chances are high.Today, the Khalus Valgus operation is focused on lower invasiveness, which is possible in combination with the good therapeutic effect of the intervention.
Indications
Khalus Valgus is a problem not only for adults, can also appear in children.The formation of the thumbnail cone in the initial phase does not disturb patients until sharp pain occurs when walking, shoe choosing problems, periodic bone inflammation.At this stage, most patients try to alleviate the pain with folk methods.Different compresses and baths only tighten the course of diseases and lead to the only true solution of Valgus deformation - surgical intervention.
Indications for operation are:
- increased pain in the thumb foot;
- Chronic inflammation, which cannot be stopped, constantly swelling;
- Damage to the skin in the curvature of Valgus (cracks, supporal, ulcers);
- Walgus Plane leg with a pronounced curved folding of the thumb;
- Inability to assist patients with conservative methods;
- The appearance of a chromium walk;
- Restricting motor activities at the foot.
Doctors insist on the treatment of Valgus thumb exclusively surgically, because most patients turn into the disease phase when it is not possible to correct the pathology conservative.At the same time, if you do not start the treatment of bones on your feet, in the end will lead to the redistribution of the cargo on the other fingers, which will make fingers suffer and bend from the second to the heel.Only with timely surgical intervention, such complications can be avoided.
Preparation for intervention
During the work for the deformation of the walgus wrist of the thumb foot, serious preparation is made in the orthopedic.The patient implements all the necessary tests.The key is the blood test, according to the results, which is important to exclude the signs of the inflammatory process in the body.
In some cases, the standard list of analyzes can be supplemented by determining the levels of hormones and oncology markers if doctors suspect the development of a malignant foot process.
The mandatory phase of orthopedic operations is X -Ray diagnosis - during the study, images are taken into two projections to determine the nature of the deformation and severity of pathological disorders.
In severe cases, doctors can resort to magnetic resonance and computer tomography.Such a study gives more precise results.According to the analyzes, doctors decide which way to be best to perform surgery.
Classification of surgical interventions
All operations performed by Valgus can be divided into two large groups - invasive work and reconstructive interventions.The first type of surgical interventions on the foot is characterized by low trauma.
Operations are used limited - only in the initial stage of disease development, if the deformation is insignificant and in the presence of a crunchillery growth, which is easily removed through surgery.In all other cases, minimal invasive operations do not solve the patient's problems.
Most minimally invasive interventions are performed quickly and does not provoke complications.Scars after such operation are minimal.The doctor makes two to three breakthroughs, whose length does not exceed 0.5 cm.After these skin operations, the skin is renewed very quickly, and the period inability to work is up to two weeks.
During reconstructive interventions, the amount of soft tissue damage is more significant.However, huge plus surgery is to help remove even significant leg deformations and help in strong curvature.The cutting cutting intervention reaches up to four inches, is located on the medial side of the foot.With such surgery, doctors completely return the anatomical position of the thumb feet.
You can also consider working operations depending on the location that runs.Three groups of interventions are different - on soft tissues, for bone tissue and combined surgery.When conducting interventions on soft fabrics, it is possible to eliminate the deformation of valgus only if there is no deformation of the head plus bones.During such an intervention, the doctor works exclusively with soft tissues - tendons, muscles, Bors.
With the surgical intervention on the bone tissue, it is possible to correct the deformation of another and third degree.The intervention is to handle a part of the bones or carry out osteotomy.With the combined operation, the intervention occurs in soft tissues and in bones.But the possibilities of such operation are expanding - doctors can remove bones growth and do the ligaments at the same time.
Operating techniques
Several operating techniques can be eliminated on their feet, each of which has its advantages and is selected with certain indications.
McBride Operation
With surgical intervention, McBraid is performed in the first interval of interflood only at the head level.Using the clamp, the doctor spreads soft fabrics and the cutter is the Internet ligament located on the surface.After that, the surgeon receives access to the tendon of the muscle, which is responsible for the distribution of the first finger - was mobilized and exceeded with special material for Suture - viril.
Furthermore, the doctor works with sesame -shaped bones, the deep package that is attached to a bone that can be removed for sesame, which is eliminated by its subbruxation.Then the capsule plusephalanx is dissected on the outer surface, after which the cut is made on the internal surface of the feet about 5-6 cm long, nervousness is released through it and redirects aside.
The capsule dissection is made in the form of English letters V, and its top is focused towards the thumb.Up above the bone and under her, the camera hooks were removed below it, the growth of cartilage on the head of metatarsal bones are removed.If this does not do so, patients in the future will feel the pain in the wrist.
In the future, the development of the operation can take place in two ways, depending on the need for osteotomy.In addition to osteotomy, there is a need to use speech that will fasten the tendon into bone fragments.The last phase removes the excess capsule tissue, plastic with a certain tissue tension is performed after which the surgeon sew edge wounds and processes its surface.
Such a technique was proposed more than eight decades ago, but to date, the operation did not lose its relevance.So, after the intervention, there are no relapse, after surgery, patients are recommended to wear special orthopedic shoes.
Seri technique
The operational technique for minimal invasive technique Seri proposed in 1998. Surgeon Cesare Faldini.It is now actively used in the surgical practice of the doctor of many countries.It refers to low -raumatic procedures and is effective in the initial stage of disease development and with moderate curved valgus foot, when the angle of the thumb feet does not exceed forty degrees.
References!The operation is not done due to heavy arthrosis.Also, patients may refuse this type of intervention with the instability of the first metatarsophalanguage joint.
The work on the foot is done under local anesthesia.The doctor states the cut in the heading of the head plus the bones of the thumb, opens the articulated capsule, carries out the osteotomy of a special file or chisel.In the process of such a procedure, you can achieve further redistribution of loads to the distal part of plus bones.
In the surgery process, doctors use Kirshner knitted needle to create a correct thumb position - starting a medial side of the spit, after which the doctor brings a finger in manual mode and places it in the right position.The operation in the process of rehabilitation requires it to be carried to plaster topping - applies at least two weeks.Speech removal was carried out after approximately 1-1.5 months.
Chevron technique
Chevron technique is used for smaller deformations if the angle is less than 17 degrees.The main condition for the implementation of such an intervention is the lack of arthrosis and other serious changes that Valgus feet brings.
Operating treatment is done as follows - in the initial phase, the doctor felling the skin just above the joint - which is called a leg.Abbreviated connections and the hinge of the capsule are different.Usually degenerative changes in tissues and ligaments are provoking the deformation of the thumb.The bone corn at the joint is removed using a chisel or file.
On the metatarhole, the cut is done at the head level, it is moved from the outside and is placed under the sesamoid bone.Then, with the help of bolts or wires, Falanx is attached, and the capsule closes.After surgery, titanium bolts do not require removal, but eliminate wire three months after surgery, if there is no need to do so earlier.
Scarf technique
In most patients, you can remove bone on your leg using joke-oosteotomy.Such an operation is performed with a moderate deformation of Valgus's first finger foot.To date, surgery is the lowest method of treatment of Valgus, has many advantages over other methods.
Positive aspects of the operation are as follows:
- The process is possible not only to move, but also to rotate the head plus bone, which allows you to achieve a more progressive result than with other surgical interventions;
- The doctor can perform an extension process with insufficient value;
- You can transfer a bone on the medial side with parsing variations;
- To reduce the load on the internal part of the foot and the first finger, you can move the bone by little and to the side;
- If necessary, you can shorten the length of the bone;
- When you find a shared joint, the bones of the elements can be rotated.
Surgical intervention is made under spinal anesthesia.The surgeon on the inside of the foot is cut off from the beginning of the finger until the beginning of the metatarzal bone.After that, a zigzag-cut cut is made on the bone side of the first finger, after which the bonehead shifts to the desired position, its angles change.At the same time, the doctor changes the location of tendons that are attached to the thumb.
The joint capsule separated from the executive was then deformed, and the bones are fixed in the desired position using titanium screws.Usually the fasteners do not remove if they do not bring discomfort, so patients and then go with bolts.Rehabilitation after surgery lasts from three to six weeks.Immediately after the intervention, patients are recommended to wear a special orthosis or tire in which it is necessary to load the foot as early as possible.The tire hurts all the time as the recovery period passes.
Laser intervention
It is also possible to remove the deformation of valgus with laser, however, patients should not be very hopes for such an operation method.Although minimally and most serious, it is used exclusively at an early stage of the development of the pathological process.
The undoubted advantage of surgical intervention is a small cut in size, which doctors do near the largest point in bone selection.After healing, such injuries is practically not noticeable, which allows you to renew the aesthetics of the foot as much as possible.With the use of lasers, doctors have the opportunity to conduct a limited intervention:
- Exporters are performed - with the help of lasers, part of cartilage growth, which is formed in the early stage of Valgus;
- Make osteotomy with a large cut - in the process of surgery, the proximal falanx of the first finger is removed;
- Execution of the resection of Arthroplasty - articulated surfaces plus bones and part of the Falan thumb were removed.
Laser removal is usually done in clinics in which there is special equipment.Recovery after surgery is minimal - in a few weeks, patients can walk normally.
The only lack of laser intervention is that the irregular position of the bone is not subject to correction, and it only becomes under the desired parameters.In this case, patients are threatened with relapses.
Arthrodeza
Work for removing valgus by Arthredez is used quite rarely, but sometimes it is the only way for patients to resolve the big finger feet.The operation belongs to the most radical intervention methods.
With the help of such an operation, it is possible to remove the base of the first finger finger finger and fix the fingers with special screws.
Important! During the operation, the main goal is achieved - eliminate deformation and give a common accurate position, but not all patients have become pleasant after such an operation.
There are serious contraindications for intervention:
- Vascular atherosclerosis and other circulatory disorders;
- Diabetic foot;
- Polineuropathy.
With arthritis and arthrosis, patients may reject both surgery if the joints are very deformed, destroyed, constantly lit.In this case, patients will advise the minimal invasive operation.
Among the complications of surgical intervention, the following pathologies may appear - severe pain, discomfort due to the structures for fastening the titanium installed in the bones.Rehabilitation after the intervention lasts eight weeks.Walking in plaster is necessary only in the first days after surgery - it is necessary to fix the elements.You can use the Barrow boot.This is especially designed orthopedic footwear that will remove the load from the washed leg.
Reviews
If the patient has a valgus removal surgery, he can read the reviews and find out what types of interventions are being carried out and how effective they are.Here are some similar opinions:
"Last year, I had to finish the Ballerine career for the finger deformation. They made a scarf according to the method, it seems that everything went well, but the leg is still in charge."
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"The bone on the leg is hereditary - even my mother and grandmother. I have made an operation as soon as the first signs appeared. All additional growth was removed on me, now the doctors said the doctors were following the possible relapses."
Walgus deformation operations in most cases allow a person to solve the problem of bones on his finger.When the first signs of Valgus appear, do not delay treatment - the best results appear at an early stage of disease development.