Valgus deformation of the first finger (thumb) is an orthopedic pathology, in which the finger is deformed, deviant.Most of the time, the disease occurs in women after 30 years.In 3%, the deformation of the valgus is detected in people aged 15 to 30, in 9% among those who are 31 to 60 years and 16% in people over 60 years of age.The problem not only causes a strong aesthetic discomfort, but also causes a change in all the ligaments, tendons, joints and bones of the foot.
Pathogenesis
With the deformation valgus of the first finger, the angle between the first and the second bones becomes more, the lag of the first metatarsal bone is observed.The thumb of the foot moves outwards and the bone head comes out, forming a bone.This bone does not allow the thumb to correspond to the standard, and it gradually deviates outwards.The tuber (bone) prevents you from wearing shoes, creates inflammation, friction and leads to inflammation of the bag of the first metatarsophalangeal joint.Little by little, the bone swells and becomes ignited, painful.The inappropriate position of the joint causes its premature wear, the cartilage lesion and an increase in the size of bone growth.This, in turn, causes the trauma of the foot and the subsequent development of pathology.As the disease progresses, the thumb moves the remaining fingers of the foot, leading to their deformation in the form of a hammer.As the disease develops, it leads to the osteoarthritis of the more noplange joints, to the inflammation of the joint bags, to the joints of the fingers, to the chronic inflammation of the bag of the first metatarsophalangeal joint, to the displacement of the first metatarsal bone, to the flat pedals (chronic and transversal), to the defaulting and the cartilsMetatarsian.
Shapes
In normal state, metatarsal bones are parallel to each other.Under the influence of certain reasons, the first metatarsal bone departs and because of this, a small bump appears on the foot, the ligaments and the tendons lose their elasticity, their dysfunction develops.
The disease has passed several stages:
- Early.At this point, the deviation of the thumb of the foot is less than 15 degrees.
- Average.The deviation of the first finger on the east side of 15 to 20 degrees.At the same time, a deformation of the second finger is observed.It rises above the thumb and becomes like a shape to a hammer.
- Heavy.The gap of the thumb is 30 degrees.All the fingers of the foot have already been distorted, and at the base of the first phalanx, there is strong bone growth.In places where there is a great tension of the foot, the raw corns appear.
Reasons
The main factor causing the appearance of the Valgus deformation is irregular shoes.If a person wears tight shoes with a narrow toe or high tacts, the fingers are constantly in poor position (compressed), which contributes to the development of the Valgus deformation.But not only does it become the cause of the development of the disease.The following reasons affect the appearance of pathology:
- Traumatic damage to the leg and the lower foot;
- rickets;
- Cerebral paralysis;
- polyneuropathy;
- low foot ark;
- flat feet;
- Congenital weakness of the muscle-ligament apparatus;
- Chronic joint inflammation caused by psoriasis;
- arthritis;
- multiple sclerosis (accompanied by damage to the shell of nerve fibers);
- diabetes mellitus;
- drop (deposit of urates in body tissues);
- Hyper of the joint mobility observed during Marthans and Down syndrome;
- Young foot (rapid increase in the size of the foot in the adolescent period);
- Charcot-Mari-Tuta disease (hereditary neuropathy, accompanied by atrophy of the muscles of the distal limbs);
- osteoporosis (bone loss);
- Stop the surface in relation to professional activities (servers, athletes, ballerinas).
In the presence of factors caused, the disease progresses rapidly.
Symptoms
The symptoms of pathology depends on the degree of damage to the foot.In the first stage, redness, swelling of the tissues in the appearance of the bone, the pain in the phalanx of the fingers, intensifying during the walking are observed.At the average stage of the development of the disease, pain, swelling, bone growth in the bone area, dry corn under the average phalanx of the finger appear.In the heavy stadium of the sole of the foot and thumb, severe and exhausting pain appear.Dry cors are formed and the keratinization of the skin appears under the second and third phalanges of the fingers.
Diagnosis
The diagnostic measures begin with the collection of the patient's anamnesis.The doctor asks him for disturbing symptoms, is interested in what causes their appearance (leg load, walking, cramped shoes), there are metabolic and systemic diseases in medical history, injuries of the lower limbs, hereditary bone diseases.Then, an external inspection is carried out, during which a person is invited to pass by.The doctor looks at the patient's approach, while determining the intensity of the pain.The position of the thumb of the foot is studied, its location in relation to the other fingers, explores the beach of its flexion and its extension.The presence of other external symptoms (swelling, redness, thickening of the stratum layer under the bones of the fingers) is verified.The coheteography of the foot is carried out in three projections in order to identify the degree of deformation of the foot, the dislocation of the joint and the related pathologies.An ultrasound of ships is carried out to exclude circulatory legs from the legs.
Treatment
The therapy of the valgus deformation of the thumb of the foot is traditional and operational.At first, when you can do without surgery, doctors advise choosing practical and correct shoes.It should not appeal to the load on the foot, friction.Comfortable shoes slow down the progression of the disease.At the same time, the doctor will advise to buy special orthopedic devices:
- Joints for the backdrop of the thumb (they eliminate the pressure from the shoes);
- Endodassen rollers, spacers that contribute to the correct distribution of the load on the foot.
All orthopedic devices reduce pain, but it is impossible to completely get rid of discomfort with their help.To eliminate pain and inflammation, non-steroidal anti-inflammatory drugs, corticosteroid injections are used.To relieve spasms and restore joint mobility, massage and special gymnastics are prescribed to relax the feet.
The effectiveness of physiotherapy
An important role in the treatment of the deformation of the valgus is played by physiotherapy.To eliminate the disease, doctors prescribe electrophoresis with calcium, phonophoresis of hydrocortisone, paraffin and Ozokeratic applications.One of the mostEffective methods of removing the deformation of the thumb valgus of the foot are therapy with shock waves (UVT).This procedure implies a short -term effect on the painful area with acoustic impulses at low frequency.UVT using the pain symptoms are eliminated, the effects on the factors that contribute to their appearance are obtained.The procedure is carried out using a special device generating shock waves.They only affect pathological areas, without affecting healthy tissues.With the help of ultrasound, metabolic processes improve.UVT is not carried out in the presence of neurological, infectious, oncological, heart, somatic, diabetes melted diseases, blood coagulation disorders.Shock waves therapy is not prescribed to pregnant women, nursing women and children under the age of 18.The effect of the procedure is observed after several procedures.The pain disappears, it becomes easier to walk.But it is impossible to completely remove the salient bone using a UVT procedure.The doctor can prescribe at least 5 to 7 sessions.Depending on the stage of the disease, the procedure of driving procedure is also prescribed.Some people are prescribed daily sessions, others will be sufficient for one procedure per week.The result of UVT treatment is held for a long time.
Surgical treatment
With an average and severe degree of deformation valgus of the thumb of the foot, surgical treatment is prescribed.To eliminate pathology, many methods have been developed by which they achieve the following objectives:
- Eliminate the bursitis of the first finger of the foot;
- Include muscles located around the damaged joint to prevent relapse of the disease;
- Reconstruction of thumb bones.
If the deformation is not strongly expressed, the growth of growth on the joint bag by a small incision is removed.After the operation, a person needs rehabilitation, with the compulsory wearing of a bandage or shoes with a wooden sole, using foot correctors, physiotherapy (at least 6 procedures).Currently, with the Valgus deformation of the thumb, the following operations are carried out:
- Small deformation correction.Small cuts are made on both sides of the thumb, through which, using miniature mills, the position of the metatarsal bones and the phalanx finger.
- Chevron-Oosteotomy.The operation is carried out with a deviation of the fingers of no more than 17 degrees.The growth is excised and the phalanx of the thumb is fixed with a screw and a titanium wire.After a while, the structure is deleted.
- Scarpe-Oosteotomy.The operation is carried out if the angle of deviation of the thumb is 18 to 40 degrees.During the intervention, using manual exposure, the position of the metatarsal bones is corrected, then fix it with two titanium screws.
The salient bone of the foot of the foot is not only aesthetically ugly, but also causes many drawbacks during walking.The disease that has not finished treating leads to complications in the work of the entire musculoskeletal system.Therefore, everything should not be authorized on equipment and contact an orthopedic if the first signs of deformation appear