Hallux valgus (hallux valgus)

Hallux valgus ("bump on the big toe", "the bone foot") is a deformity of the foot, which is the curvature of the thumb outwards. This deformation is widespread, found in 25 % of the adult population. The curvature can be found in children, in this case it was congenital. Hallux valgus is usually diagnosed in women. With the fair sex, the curvature of the bone occurs ten times more often than men. This is because women bond over the weaker, the situation is worsened by wearing uncomfortable tight shoes. Pathology is the diagnosis in all age groups.

The bones of the foot

When the curvature of the thumb is very much greater than between the first and second metatarsal bones. As a result, the first bone moves inside, and your finger, which is held by muscles, which move outwards. The head forms a tubercle (it is often called "bones" or "bump"), as a result of constant interactions with the shoes head is inflamed and red, increase the sensitivity. This may cause bursitis – inflammation of the lining of the bag replacement.

Causes Of Hallux Valgus

There are several reasons due to which deforms the big toe.

  • The first group of reasons, which is called with a deficiency of connective mechanics, then there is a prolonged disruption of biomechanics of the first joint associated with the thumb. This may cause the transverse platypodia, varicose veins, increased mobility of joints, excessive stretchability of the rope.
  • The second group of reasons, which include congenital deformity, trauma, and certain neurological diseases (e.g., polio).
  • A third group of hereditary predisposition to the disease. Usually the nearest relatives of the so strain (moms, aunts, grandmother).

Other factors, such as walking in uncomfortable shoes (narrow, short or tight), wearing high heels – they are secondary. They only contribute to the development of the deformity, if there is a predisposition.

Symptoms

The main symptoms of thumb deformity:

  1. The seal in the region of the first toe.
  2. The pain of a various degree of curvature. The pain varies in nature, and the forces can cause discomfort and may be sharp and searing. Pain worse after prolonged standing or wearing uncomfortable footwear. You can disturb the patient at night. During the rest of the pain go away. Pain is not always correlated with the size of the deformation, but if the head is displaced significantly, the symptoms and pain are intensified.
  3. Obvious deformity – the head of the first bone is displaced inward, and the thumb itself is displaced outwards.
  4. Swelling and redness of the soft tissues in the area of the thumb.
  5. The presence of large maize, which is formed in place of the compression of the soft tissue "lumps".

Sometimes, x-ray of the metatarsophalangeal joint, it is possible to detect a subluxation of the first toe. Occasionally, Hallux valgus in combination with other deformities (flat feet and hammer toes).

The reasons for the development of HalluxValgus

Diagnosis

Diagnosis of the disease is the doctor. Initially, the doctor listens to patient complaints, request clarification of issues relating to the load on the foot, heredity, strain. Then the doctor performs a examination brake and awarded the x-ray study of the 1 metatarsophalangeal joint of the thumb. For a more detailed study can be assigned to the radiograph 2 and 3 foot aggregate.

The diagnosis put on the basis of symptoms and x-ray data. After the diagnosis the doctor prescribe the treatment. In some cases, the doctor may prescribe the passage of magnetic resonance imaging of the foot.

Rate

The degree of Hallux valgus is expressed in two quantities: the angle between the 1. and 2. metatarsal bone and as the deviation of the big toe 1 metatarsal bone. According to these parameters, there are three stages of the disease Hallux valgus.

  • 1 degree – the angle between the first and second metatarsal bones has a value of less than 12 degrees, the deviation of the thumb is less than 25 degrees.
  • 2 the extent of the disease is characterized by the deformation the angle between the metatarsal bones is less than 18 degrees, and the angle of deviation of the first toe greater than 25 degrees.
  • Stage 3 (final) is determined by the deformation the angle between the metatarsal bones of more than 18 degrees, and the angle of deviation of the first finger 35 degrees.

Conservative treatment

The deformation of the thumb cannot be removed without a surgical operation. But with a small curvature it is possible to live a full life . If the patient is only the initial stage of the disease, doctors prescribe conservative treatment. It is also prescribed for older patients and older people, regardless of the degree of deformation.

Conservative treatment includes:

  • wearing special orthopedic shoes, which eliminates the interaction between the painful "bump" and shoes,
  • wearing interdigital pads
  • the correction of way of life, it is important to normalize body weight, regular physical activity,
  • the use of arch supports (insoles) to adjust the arches of the foot.

In addition to these procedures, the medications used. Medications designed to relieve pain. As a rule, prescribe medications from the group of nonsteroidal anti-inflammatory medications to relieve pain and inflammation. Severe pain it is advisable to lubricate the place of the deformation of the anti-inflammatory ointments. Doctors may prescribe for patients receiving the physiotherapeutic procedures: magnetic therapy, phonophoresis, paraffin treatment, inductothermy.

In cases where multiple courses of conservative treatment, has proved to be ineffective, the doctor prescribes surgery.

Surgical treatment

All the surgical operations, which are divided into three groups:

  • interventions are carried out on soft tissues,
  • operations on the bones
  • interventions carried out on the bones and the soft tissues at the same time.
Insole

Operations on soft tissues, it is considered that it is effective only on the first level of the deformation. During the operation of the silver doctor cuts the tendon of the adductor muscles of the thumb. During the surgery McBride the kite move. These measures can be carried out in connection with the operation, which removes bone growth and subcutaneous bag of the first metatarsophalangeal joint.

If the patient has second or third degree Hallux valgus, in this case, the conduct of operations on the bones, or surgery on bones and tissues. Perhaps the use of the Chevron osteotomy. In this case, the doctor removes a small, v-shaped piece of the distal part of the first metatarsal bone.

When Scraft performed osteotomy cut (Z-cut) for all of the metatarsal bones of the thumb. Then move the particles, the particles are fixed with screws.

Surgical operations carried out in the trauma and orthopedic departments. Postoperative period lasts about 6 weeks. In the meantime, the patient can load the leg in a special knee brace. The patient should avoid overloads, often to the leg above the level of the body.

After removal of the orthosis, the patient is recommended to wear comfortable walking shoes (wide and without heel), complete a course of special gymnastic exercises, self-massage your foot with a tennis ball.

What doctor to address

The deformation of the thumb should consult with your doctor. Determined by the extent of the disease, prescribe the appropriate treatment. You will help the orthopedist, traumatologist or surgeon. You can also consult with your doctor and endocrinologist.

Qualified medical assistance, which will help to cure the defect, eliminate the cause and restore the foot.

14.09.2018