Valvular deformation of the toe is so common that in medical practice you can calculate over four hundred ways to choose the problem.Of course, not all interventions have achieved the same success and completely addressed the patient’s problems, so in modern practice the most progressive choices for intervention remain, where the patient’s chances of recovery are high.Today, the focus of Khalus valgus operation is to be used as low as possible in combination with the good therapeutic effect of the intervention.
Indications
Harlus' reblooding is not only a problem for adults, but can also appear in children.The formation of a cone on the thumb legs in the initial stage will not interfere with the patient until severe pain occurs while walking, problems with the choice of shoes, and periodic inflammation of the bones.At this stage, most patients try to relieve pain through folk methods.Various compression and baths only tighten the disease process and cause valgus deformation - the only real solution to surgical intervention.
The instructions for this operation are:
- Increased pain in the toe;
- Chronic inflammation, unable to stop, constantly swelling;
- Damage to the skin in valgus curvature (cracks, suppuration, ulcers);
- planena gus feet, obvious curvature of toe joint;
- Cannot help patients who use conservative methods;
- la foot gait appearance;
- Restrict foot movements.
Doctors insist on surgical treatment of thumb, because most patients turn at the stage of the disease when they cannot conservatively correct the pathology.Meanwhile, if you don't start processing the bones on your legs, it will eventually lead to a redistribution of load on other fingers, which is why the fingers suffer and bend from the second to the fifth time.This complication can only be avoided through timely surgical intervention.
Prepare for intervention
During the operation, the valgus of the joints of the toe were deformed and severely prepared in orthopedics.The patient performs all necessary examinations.Their key is blood tests, based on the results of the signs of inflammatory processes in the body.
In some cases, a standard list of analysis can be supplemented by determining the hormone and marker levels of oncology, if the doctor suspects the development of malignant processes in the foot.
The mandatory phase of orthopedic operation is X-ray diagnosis - during the study period, in order to determine the nature of the deformation and the severity of the pathological disease.
In difficult situations, doctors can resort to magnetic resonance or computed tomography.Such research gives more accurate results.Based on the analysis, the doctor decides to perform the operation best.
Classification of surgical interventions
All operations completed by the valgus can be divided into two large groups - invasive operations and reconstruction interventions.The first surgical intervention on the foot is characterized by low trauma.
Operation is limited - This is easily removed surgically only in the initial stages of disease development if deformation is insignificant and in the case of benign growth of cartilage.In all other cases, minimally invasive procedures do not solve the patient’s problem.
Most minimally invasive interventions are performed quickly and do not cause complications.The scars after this operation are very small.The doctor's two to three punctures shall not exceed 0.5 cm in length.After these surgeries, the skin recovers quickly and the working capacity lasts for up to two weeks.
During the reconstruction intervention, the amount of damage to soft tissue is greater.However, a large part of the operation is that they help eliminate significant deformation of the legs and help with severe bending.The incision for the reconstruction intervention can be up to four centimeters, located on the medial side of the foot.Through this surgery, the doctor completely restored the anatomical position of the toe.
You can also consider operations based on where it is performed.Distinguish three groups of interventions - on soft tissue, bone tissue and combinatorial surgery.When intervening with soft fabrics, it is possible to eliminate tilt deformation only if the head is deformed without bones.During this intervention, doctors work specifically with soft tissues - tendons, muscles, bones.
Second and third-level deformation can be corrected through surgical intervention on bone tissue.The intervention is to submit a part of the bone or perform an osteotomy.Through the merge operation, intervention occurs both in soft tissue and in bone.But the possibility of this surgery is wider - doctors can simultaneously remove bone growth and create ligaments.
Operational technology
Several operating techniques can be eliminated on the legs, each with its own advantages and certain signs.
McBride Action
With surgical intervention, McBride performed only at the first interval at the head level.Doctors use clamps to spread soft fabrics and cut into interflood ligaments located on the surface.Afterwards, the surgeon obtained the passage of the muscle tendon, which was responsible for the distribution of the first finger - it was mobilized and sewn by a special suture material - Vikril.
Additionally, the doctor works with the SESAM-shaped bones, who passes through a deep bundle attached to the SESAM-shaped bones, which is eliminated by its subluxation.The capsule of the nephalanx joint was then dissected on the outer surface, and the incision was performed on the inner surface of the foot about 5-6 cm long, through which the nerves were released and transferred to the side.
The anatomy of the capsule is carried out in the form of the English letter V, with peaks aimed at the thumb.From above and below the bone, the family hook was removed under it, removing cartilage growth from the meta bone.If this is not done, future patients will suffer pain in their joints.
In the future, according to the need for osteotomy, the development of operations can be carried out in two ways.Using osteotomy, a spoke that connects the tendon to the bone fragment is required.In the final stage, excess tissue from the capsule is removed and some tissue tension is performed, and the surgeon then sews the wound edge and treats its surface.
This technique was proposed more than eighty years ago, but to this day, the operation has not lost its relevance.Therefore, after the intervention, there is no recurrence after the operation, and it is recommended that patients wear special orthopedic shoes.
Seri Technology
In 1998, surgeon Cesare Faldini proposed the operational technology of Seri's minimum invasion technology.Now, it can also be actively used in surgical practices of doctors in many countries.It refers to a low traumatic procedure that is effective in the initial stages of disease development and the initial stages of medium lateral curvature of the foot, when the skew angle of the foot's toe does not exceed 40 degrees.
refer to!Due to severe joints, the surgery is not performed.Furthermore, patients can reject this type of intervention, while the instability of the first metatapophangeal joint.
The surgery on the foot was performed under local anesthesia.The doctor cuts an incision while projecting the head of the thumb bone, opens the joint capsule, and performs osteotomy with a special document or chisel.During this process, you can further redistribute the distal part of the bone.
During the surgery, the doctor uses Kirshner's knitting needles to create the correct position of the thumb - they start from the spitting direction on the inside of the surface, after which the doctor brings the fingers to the correct position in manual mode and sets them in the correct position.Operations during rehabilitation require wearing of plaster seasoning - at least two weeks.A strike took place in about 1-1.5 months later.
Herringbone technology
If the angle is less than 17 degrees, a smaller deformation is performed using herringbone technique.The main condition for implementing this intervention is the lack of arthritis and other serious changes, which can cause emanation of the foot.
The procedure is handled as follows - In the initial stage, the doctor cuts the skin above the foot joints on the foot.Shortening the connection and the joint capsule are differentiated.Often, degenerative changes in tissues and ligaments can cause deformity in the thumb.Use a chisel or file to remove bone corn from the joints.
On the meta bone, make an incision at the level of the head, which moves outside and is mounted under the sesame bone.Then, with the help of screws or wires, the cracks are connected and the capsules are closed.After the surgery, the titanium screws do not need to be removed, but they eliminate the wires if not earlier than the surgery three months after the surgery.
Scarf technology
In most patients, you can use a scarf-dental surgery to cut the bones on your legs.This operation is performed with a medium outward deformation of the first finger of the foot.This procedure has by far been the most versatile method for treating valgus, and it has many advantages over other methods.
The positive aspects of the operation are as follows:
- In the process, not only is it possible to change, but the bone-plugged head can be rotated, which gives you more gradual results than other surgical interventions.
- The doctor’s value is insufficient to perform extended procedures;
- By deforming, you can move the bones inside.
- To reduce the load on the feet and inside the first finger area, you can move the bone down to the side;
- If necessary, you can shorten the length of the bone;
- When placed in a joint, the bone elements can be rotated.
Surgical intervention was performed under spinal anesthesia.The surgeon inside the foot starts from the beginning of the finger to the beginning of the metabolite.After that, a serrated incision is made on the side of the bone of the first finger, and the head of the bone is moved to the desired position, with the angle changing.Meanwhile, the doctor changes the position of the tendons, which are attached to the thumb.
The deformed joint capsule is then separated from the outer part and the bone is secured in the desired position using titanium screws.Usually, if the fastener does not cause any discomfort, the fastener will not be removed and then screws are used.Recovery after surgery takes three to six weeks.After the intervention, patients are advised to wear special orthosis or tires immediately, where it is necessary to load their feet as early as possible.When the recovery period passed, the tires were in a hurry.
Laser intervention
The valgus deformation can also be removed with lasers, but the patient should not be highly desirable for this surgical method.Although it is the smallest and mildest, it is only used in the early stages of pathological processes development.
There is no doubt that the advantage of surgical intervention is a small incision, the distance between the doctor at the maximum point on the ledge of the bone.After healing, this damage is not actually obvious, which allows you to restore the aesthetics of your feet as much as possible.Through the use of lasers, doctors have the opportunity to conduct limited interventions:
- The resection was performed with the help of lasers, and a portion of the cartilage growth was removed, which was removed in the early stages of valgus.
- During the operation, osteotomy is performed in large quantities to remove the proximal bone of the first finger;
- Perform resection arthroplasty - removes the joint surface of the bone and the surface of a part of the thumb bone.
Laser removal is usually performed in clinics with special equipment.Recovery after surgery is at least - after a few weeks, the patient can walk normally.
The only disadvantage of laser intervention is that the incorrect position of the bone is not constrained by correction and grows only under the required parameters.In this case, the patient is threatened with relapse.
Joint fixation
Surgery to remove valgus by arthroplasty is rarely used, but sometimes it is the only way for a patient to get rid of his feet.This operation is the most radical intervention method.
With the help of this surgery, the bottom of the edge of the first finger of the foot can be removed and the fingers are secured with special screws.
Important!During the operation, the main goal was achieved - eliminating deformation and giving the joints the correct position, but not all patients became comfortable after this surgery.
There are serious contraindications for intervention:
- Angiosclerosis and other circulatory diseases;
- Diabetic feet;
- Multiple neurotic.
With arthritis and arthritis, if the joints are very deformed, damaged, and constantly inflamed, the patient can also refuse surgery.In this case, the patient will recommend minimally invasive surgery.
In complications of surgical intervention, the following pathology may occur due to discomfort caused by the titanium fixation structure installed in the bone.The recovery after intervention lasted for eight weeks.Walking in the cast is only required for the first few days after the surgery - this is a necessary condition for repairing the elements.You can use Baroka boots.This is a specially designed orthopedic shoe that can remove loads from the operating legs.
Comment
If the patient has surgery to eliminate citrusion, he can read the reviews and find out what types of interventions are taken and how they are effective.Here are some similar views:
"Last year, I had to complete my career as a ballerina due to the deformation of my fingers. They made scarves according to the method and it seemed that everything was going well, but my legs were still hurting on the burden."
"I've been suffering for a long time, but I dare not go to the surgery. I was caused by complicated joint fixation and it took two and a half months to recover, but after the surgery, it became easier. Now, I can walk without a stick and not torture the pain."
"The bones on my legs are hereditary - even my mother and grandmother have gout. I decided to have surgery immediately after the first sign appears. The surgery was with a laser, all the extra growth was moved to me, and the legs look normal now, but the doctor said it might follow a possible relapse."
In most cases, the valgus deformation operation allows one to solve the bone problems on the fingers.Do not postpone treatment when the first sign of valgus appears - the best results occur in the early stages of disease development.