Hallux Valgus has more than four hundred options for surgical resolution of this problem in medical practice that is so common.Of course, because all the interventions do not have equal success and completely resolved the patient's problem, the most progressive intervention options in modern practice, the most progressive intervention options have the most progressive intervention option.Today, Hallux Valgus surgery focuses on becoming as invasive as possible with a good therapeutic effect of the intervention.
Thing
Hallux Valgus is not just a problem for adults;May also appear in children.At the initial stage, the occurrence of a part of a large finger, pedestrians, shoes, problems with problems and periodic inflammation of the bone do not disturb the patients.At this stage, most patients try to eliminate pain using traditional methods.Different compressions and baths extend only the course of the disease and cause the only correct solution to the deformation of Hallux Valgus - Surgical intervention.
Tips for operation:
- Growing pain in the big bush;
- You can't stop, constant swelling;
- Damage to the skin in the region of Valgus curvature (cracks, probability, ulcers);
- The plan for the grave of the great finger of Valgus;
- Inability to help patients with conservative methods;
- appearance of a collapse site;
- Restriction of motor activity on the foot.
Doctors insist only in surgical treatment of the thumb, as most patients are treated if it is not possible to correct the pathology in a phase of the disease.At the same time, if the bunions were not cleared, the bunions will eventually cause the burden to the other toes, the second is the second to eliminate the fifth fingers and being crooked.You can only prevent such complications with surgical intervention in time.
Are prepared for intervention
Serious preparations are underway in Orthopedics during the operation for the Hallux Valgus.The patient passes through all the necessary tests.The key is a blood test, the results are important to exclude signs of an inflammatory process in the body.
In some cases, the standard list of tests can be added to determine the level of hormones and cancer if the doctors suspect the development of a malignant process on the leg.
A compulsory stage of orthopedic transactions is X-ray diagnosis - during work, images are drawn in two forecasts to determine the severity of deformation and pathological disorders.
In difficult cases, doctors can apply magnetic resonance imaging or computer tomography.Such a job gives more accurate results.According to the results of the tests, doctors decide which method is best to perform the operation.
Classification of surgical interventions
All transactions made for Valgus can be divided into two large groups - minimally invasive transactions and reconstructive interventions.Characterized by the lower trauma of the first type of surgery in the leg.
Operations are used in limited extent - only in the initial stage of the development of the disease, the deformation is insignificant and is due to the development of cartilage tissue that can be easily demolished through surgery.In all other cases, minimally invasive transactions do not solve the patient's problems.
The most minimum invasive interventions are performed quickly and does not cause complications.After this operation, the tracks are minimal.The doctor makes two to three punctures for interference, not more than 0.5 cm in length.After these operations, the skin recovers very quickly and the period of disability is up to two weeks.
When performing reconstructive interventions, the volume of soft tissue damage is more important.However, a great advantage of the operations is that the feet will help to help a significant deformation and heavy curvature.During reconstructive intervention, the incision reaches four centimeters and is located on the medial side of the foot.With this type of operation, doctors completely restore the anatomical position of a large finger.
You can also review the operations depending on where they are implemented.There are three group intervention - in soft tissues, in bone tissue and combined operation.When interventions in soft tissues, Valgus deformation can only be eliminated if the deformation of the metatarsal head is not deformed.During such an intervention, the doctor only works with soft tissues - tendons, muscles, Bursa.
It is possible to adjust the second and third grade deformations with surgical intervention in bone tissue.Involves part of the intervention or the performance of osteotomy.In a combined operation, both soft tissue and bone intervention occur.However, the possibilities of such a transaction are wider - doctors can delete a bone growth at the same time and ligament can hold a plastic operation.
Operating methods
Bunions can be eliminated using several surgical methods, each of which is selected for their advantages and certain hints.
Operation McBride
According to McBride, an incision in the first intermediate space during surgery is only at the level of heads.Using the jealous, the doctor breaks soft tissues and makes an incision in an intermetarsal ligament on the surface.After that, the surgeon gets access to the tendon of muscles responsible for missing the first finger - it moves with a special sewing material - Vicryl.
Then the doctor works with Sesamoid bones;The deeper ligament, which glued to the sesamoid bone, thus eliminates the sublesis.Then the capsule of the metatarsophalangal combination is broken down along the outside surface, after which this nerve isolated and withdrawn, about 5-6 cm long, about 5-6 cm long.
The splitting of the capsule was designed a British V, and the mug was directed to the thumb.Homan's hooks are placed on top of the bone and cartilage growth in the top of the metatarsal bone.If this is not done, patients will feel joint pain in the future.
In the future, the development of the transaction may occur in two ways depending on the need for osteotomy.With osteotomy, you need to use a pin that will connect the tendon to bone fragments.In the final stage, the capsule texture is already removed, plastic surgery is carried out by a certain tension, then the surgeon builds the edges of the wound and treat the surface.
This technique was offered more than eight decades ago, but so far the operation did not lose relevance.After the intervention, patients are recommended to wear special orthopedic shoes after the operation of patients to prevent relapses.
Seri method
Surgical techniques using minimum invasive series equipment were offered by Surgeon Faldini in 1998.Now many countries are actively used in the surgical experience of doctors.This is effective in the initial phase of a low traumatic procedure and the development of the disease and the middle-class curvature of the foot, the staging angle of the great finger does not exceed forty degrees.
Speed!The operation is not carried out due to heavy arthrosis.This type of intervention may be rejected when patients are unstable in the first metatarsofalangal joint.
The foot operation is carried out under local anesthesia.The doctor makes an incision in the project of the head of the METATARSAL Bone, opened a joint capsule and performs an osteotomy with a special file or chisel.During this procedure, it is possible to further share the cargo in the distal part of the metatarsal bone.
During the surgical procedure, doctors use Kırschner wires to create the correct position of the thumb - they are included in the medial side of the surface in the direction, and then put the doctor's finger manually and puts the finger.During the rehabilitation process, the operation requires plastering to wear the casting - at least two weeks applied.The needle is released in about 1-1.5 months.
Chevron method
When the angle is less than 17 degrees, Chevron technique is used for small deformations.The main condition for such an intervention is the lack of arthrosis and other serious changes caused by the foot valve.
Surgical treatment is carried out as follows: At the initial stage, the doctor cuts the skin above the metatarsofalangal combination of the leg.Shortened links and joint capsule are emphasized.Typically, degenerative changes in tissues and ligaments are provoked by the deformation of the thumb.The connection is removed using a chisel or use a saw.
A cut to the metatarcal bone, the head level, moved beyond and placed under the sesamoid bone.Phalanx is then provided using screws or wires and closes the capsule.Titaneal screws do not require removal after surgery, but this is to be done for three months after the operation, if this should be done before.
Scarf method
In most patients, Bunion can be removed using a scarf osteotomy.This operation is performed for the deformation of the mild valgus of the first leg.Today, surgery is the most universal method of treatment of valgus;Has many advantages in other ways.
The positive aspects of the transaction are:
- During the procedure, it is possible to change only in turn, but also it is possible to turn the metatarsal bone, which allows you to get more progressive results than other surgical interventions;
- If the size is not enough, the doctor can make a bone stretching procedure;
- The bone can go to the medial side with varus deformation;
- To reduce the load inside the foot and the area of the first leg, you can transfer the bone to a little down and side;
- If necessary, you can shorten the length of the bone;
- When a joint awarded, the bone elements can turn.
The operation is carried out under the spinal anesthesia.The surgeon makes a cut from the beginning of the foot inside the leg in the leg to the beginning of the metatarsal bone.After that, a zigzag was cut off on the side of the bone of the first leg, and then the head of the bone is changed to where the bone will want to be a change.At the same time, the doctor also changes the place of tendons connected to the thumb.
Then the deformed articular capsule is separated from the outside and the bones are stable in the required situation using titanium screws.Usually fasteners are not removed;If they do not cause any concern, patients continue to wear screws.After the operation, rehabilitation takes three to six weeks.Immediately after the intervention, patients are recommended to be a special oroz or fragmentation that needs to be downloaded as early as possible.Try to break down throughout the recovery period.
Laser intervention
It is also possible to remove Hallux Valgus with a laser, but patients should not have high hopes for this operating method.Although the minimum invasive and the most delicate, it is only used in the first stage of the development of the pathological process.
Survincious advantage of surgery is a small incision that approaches doctors to the biggest point of the bone.After healing, such an injury is practically invisible, which allows the maximum restoration of the aesthetics of the foot.Using the laser, doctors can make limited interventions:
- Take exostaectomy - Using a laser, a part of the cartilage growth that occurred in the early stage of Valgus is removed;
- Make a osteotomy with a large cut - the proximal Phalix of the first leg was removed during the operation;
- Resection Arthroplasty - Articular surfaces of a part of the metatarsal bone and a large finger are removed from the articulated surfaces.
Laser removal is carried out in clinics where there are generally special equipment.After the operation, the restoration is minimal - patients can travel normally in a few weeks.
The only deficiency of the laser intervention is the correction of the wrong position of the bone, but the basis for the required parameters.In this case, patients are at risk of relapse.
Arthodes
Surgery is very rarely used today to remove Valgus using the arthrodes, but sometimes the only way patient is to get rid of the valve of the great finger.Surgery is one of the most rooted methods of intervention.
With the help of such a transaction, it is possible to delete the basis of Phalanx of the first leg and correct the toes with special screws.
Important! During the operation, the main goal is achieved - to eliminate deformation and give the correct position in the joint, but after such surgery, all patients are not comfortable.
The intervention has serious reflection instructions:
- Vascular Atherosclerosis and other blood circulatory disorders;
- diabetic foot;
- Polineuropathy.
The joints with arthritis and arthrosis are severely deformed, or are constantly inflamed, patients can also be deprived of surgery.In this case, patients will be recommended to work in minimal invasive surgery.
Among the complications of surgical intervention can occur: severe pain, severe pain, anxiety, anxiety due to the structures of Titan settled in the bone.After the intervention, rehabilitation lasts eight weeks.Only after surgery, you need to walk in a cast in the first days - it is necessary to correct these elements.You can use the baruk's draw.These are specially designed orthopedic shoes that will release stress from the power.
Reviews
If a patient has a transaction to eliminate the valve, you can read reviews and learn what types of interventions and how effective.Some similar ideas:
"Last year I had to end like a ballerina as a ballerina using a Hallux Valgus deformation. We used it to have a scarf method, but everything seemed good."
I have been suffering from the Hallux Valgus for a long time, but I dared to hold an operation.I had a complex artistry.
"The bone in my feet - My mother and grandmother also suffered from Gut. The first signs were seen as visible.
In most cases, transactions for the Hallux Valgus allow you to solve a bunion problem in a man's finger.When Valgus's first signs appear, you should not delay the treatment - the best results appear in the early stage of the development of the disease.