Valgus deformity of the big toe of the foot: treatment, surgery and rehabilitation
Drug treatment and operational correction of valgus deformation of the big toe
Hallux valgus is considered one of the most common orthopedic disease. It manifests itself in the curvature of the big toe and looks like a kind of lump near the base.
Since this disease develops slowly, it is quite difficult to detect in the early stages, which leads to pain and various complications.
Under valgus deformity understand the pathology of the foot, in the development process which bends the metatarsophalangeal joint of the big toe. As a result, its phalanges are at an angle relative to each other.
Eventually one of them starts to bulge in the direction of the head of the bone. This leads to the formation of bumps on the external side of the foot. Sometimes this process is accompanied by pain.
Frequently valgus deformation of the big toe accompanied by poor circulation, which provokes arthritis or osteoarthritis. If you don’t provide proper treatment, may develop chronic bursitis, sometimes a traumatic tenosynovitis.
To the development of hallux valgus first toes can lead to the following factors:
- flat feet;
- congenital disorders of the finger joints or the foot;
- weak or too movable joint;
- destruction of the joints as a result of arthritis or arthrosis;
- traumatic injuries of the foot.
Wearing tight shoes is not the cause of development of this pathology, however it can speed up the process or complicate its course.
Therefore, valgus deformity of the first toe is quite common in women who wear shoes with heels.
There are diseases that provoke the development of disease. These include:
- Osteoporosis. This pathology is accompanied by loss of calcium from bones, causing them to alter their structure. That is what is the cause of deformity.
- Flat feet. Almost all patients with valgus deformity of the foot has a lateral and longitudinal flat feet.
- Endocrine disorders. These processes often lead to the weakening of the ligament that eventually triggers flatfoot and deformity.
At risk are:
- People who wear uncomfortable shoes. High heels and tight shoes increase the load on the foot, which leads to accelerating the development of hallux valgus.
- Women. Usually this disease is diagnosed more often in women, likely due to the fact that they often wear uncomfortable shoes.
- Ballerina. The representatives of this profession a lot of time dancing on the toes, which increases the risk of developing hallux valgus.
- Older people. It is believed that the frequency of this disease increases with age. So, people have 15 to 30 years this figure is just 3 %, and after 60 years it increases to 16 %.
- People with a genetic predisposition. Scientists believe that there is a direct relationship between the development of hallux valgus and the presence of this disease in close relatives.
Symptoms of the disease
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This disease develops slowly, and therefore it is difficult to see. At first it seems that the usual shoes became uncomfortable.
Still having pain in the feet.
Appears gradually the main symptom – deviation of the big toe and the formation near its base the so-called bones. While the rest of the fingers take on the form of hammers. The person may suffer from fatigue or have difficulty when choosing shoes. Also, he might be corn, hindering walking.
The main symptoms of hallux valgus include the following:
- appears soft formation, which is accompanied by the fact that the skin in the area of the joint becomes red, the pain appear as inflamed joint capsule;
- the thumb changes its shape, becoming crooked;
- in the area of the first phalanx forms a solid lump;
- develops callus, irritated skin;
- there are pain while walking;
- the thumb loses its mobility. Over time, physical activity can lose and the other fingers.
There is a simple classification, according to which there are several stages of the development of hallux valgus:
- 1 degree. Is offset from the toe of less than 20 degrees. In this case, the discomfort absent.
- 2 the degree. The joint is shifted 20-30 degrees. In this situation the person feels a slight pain.
- 3 degree. The shift joint on 30-50 degrees. In this case, there is a steady pain in the big toe. These feelings do not allow a person to do his actions in full.
- 4 the degree. The joint shifted more than 50 degrees. This state is characterized by pronounced sensations of pain, discomfort when walking, difficulty Shoe selection, the formation of blisters.
To make an accurate diagnosis, the physician should examine the patient for the presence of comorbidities and to conduct external examination. In this procedure, a specialist will need to assess:
- the gait of the patient;
- the position of the big toe;
- the prominent position of the joint;
- range of motion of the thumb;
- the presence of keratosis;
- the presence of associated deformities.
In addition, if you suspect a valgus deformity of the first toes, you may need additional types of research:
- The x-rays. This procedure is performed in three projections shows changes in the position of the stop.
- Computer plantography. On a special platform raises the foot print, and its analysis provides an opportunity to talk about the load distribution.
- Computer podometry. By using this technique could determine changes of the foot at an early stage and prevent the development of disease.
It is very important to differentiate the diagnosis from other diseases – gout, arthritis, osteoarthritis.
The complex of therapeutic measures
The choice of tactics of treatment of valgus feet is affected by the degree of severity and the level of pain. Of course, the most effective treatment is at an early stage of the disease, because it allows to prevent deformation of the joint.
Treatment can be conservative or surgical. In addition, to reduce the symptoms of the strain are capable of using orthopedic shoes.
Therapy hallux valgus of the first toe of the foot usually start with a comfortable Shoe that does not cause stress or friction. In the early stages of pathology is able to stop the progression of the deformity.
Since pain sensations arise from pressure of the Shoe, then the treatment is to remove precipitating factor.
To reduce pressure, use special pads. In addition, there are many devices that change the load distribution.
In the course of treatment of the disease is usually prescribed medications that have anti-inflammatory effect. Good effect of local administration of steroids. These include kenalog, hydrocortisone, diprospan. Usually these drugs are administered in the form of injections directly into the affected joint.
Be aware that drug therapy is not able to save people from this disease. With the help of such injections can only reduce the pain and remove the inflammation.
For the treatment of hallux valgus can be used and physiotherapy treatments – ultrasound or diathermy. You need to consider that these events give a temporary effect.
The most effective is the use of orthopedic products, which are made individually after the study of foot shape and gait of the person.
The use of different insoles, correctors of the toes and interdigital folds at the beginning of illness can stop the subsequent deformation. If the process is running, the use of such products may be only slightly reduce pain. With our custom insoles are able to correct the violation of the arch of the foot.
Surgery for hallux valgus is usually required in cases when conservative treatment does not bring the desired results. The choice of method is determined by the stage of the disease:
- Remove «build-up». In moderate cases, the operation removes only the knot on the bag of the joint. To do this, perform a small incision and a special chisel to eliminate the build-up.
- Distal osteotomy. In this case, the cut distal end of the bone and moves so as to decrease the angle between bones metatarsalgia.
- The proximal osteotomy. In this case, the proximal end of the bone cut of the first metatarsal bone.
After that, the surgeon performs the osteotomy. Using this procedure it is also possible to decrease the angle between bones metatarsalgia.
- The Operation Of The Keller-Brandes. In this case, remove the big toe joint, and the remaining capsule is sutured to the damage between the proximal phalanx and metatarsal bone.
Surgery for hallux valgus stop is considered the most effective method of correcting hallux valgus and is used in most cases.
Rehabilitation after surgery
To the postoperative period has passed successfully, you must perform the following recommendations:
- to wear shoes with wooden soles or use a special brace;
- to use crutches so as not to focus on the injured leg;
- physical therapy, if needed;
- use shoes with wide toe box;
- use of orthopedic markers.
Note that the operation can lead to dangerous consequences:
- getting an infection in the soft tissue;
- the development of osteomyelitis;
- slow Union of bone after dissection;
- the displacement of the bone fragments;
- numbness of the skin in the area of the incision;
- the development of arthritis or avascular neurosis after surgery.
In order to identify the beginning of the development of the disease, should be regularly examined by a podiatrist.
To prevent this disease are advised to wear comfortable shoes with a low heel. It should be made from natural material and do not have sharp noses.
It is also recommended to use orthopedic insoles. If you have for a long time to stay on your feet, you need to stick to the regime of work and rest.
Valgus deformity of the big toe is a serious disease that significantly impairs quality of life. While its treatment is the most effective in the early stages of development, so do not neglect visits to the podiatrist, especially if you are at risk.