The valgus deformation of the first (thumb) finger is an orthopedic pathology in which the finger is deformed and deviates.Most of the time, the disease occurs in women after 30 years.In 3%, the valgus deformation is determined in people aged 15 to 30 years, in 9% in people between 31 and 60 years, and 16% in humans over 60 years.The problem not only causes strong aesthetic symptoms, but also leads to a change in all ligaments, tendons, joints and foot bones.
Pathogenesis
With the valgus deformation of the first finger, the angle between the first and second bones becomes more plus, the shift in the first midfoot bone is observed.The thumb of the foot shifts outwards and the bone head sticks out and forms a bone.This bone does not allow the thumb to correspond to the norm, and it gradually deviates to the outside.The tubercle (bone) prevents you from wearing shoes, inflammation, friction and leads to inflammation of the bag of the first metatarsophalangeal joint.Gradually the bone swells and is inflamed, painful.The improper position of the joint provokes its premature wear, the lesion of the cartilage and an increase in the size of bone growth.This in turn provokes the trauma of the foot and the further development of the pathology.In the course of the disease, the thumb changes the remaining fingers of the foot, which leads to its deformation in the form of a hammer.While the disease develops, it leads to arthrosis of the plus nopy joints, inflammation of the joint bags, the fingers of the fingers, the chronic inflammation of the pocket of the first metatarsophalangal joint, the shift of the first metatarsal bones, flat pedes (chronic and transversal), bones and bones and bone bones), augmentum head metatarsal.
Shape
In normal condition, the midfoot bones are parallel to each other.Under the influence of certain reasons, the first midfoot bone evades, and for this reason a small bump occurs on the foot, the ligaments and tendons lose their elasticity, their functional disorders develop.
The disease organizes several stages:
- Early.At this stage, the deviation of the thumb of the foot is less than 15 degrees.
- Average.The deviation of the first finger to the side is between 15 and 20 degrees.At the same time, a deformation of the second finger is observed.It rises over the thumb and becomes a hammer like a shape.
- Difficult.The deviation of the thumb is 30 degrees.All fingers of the foot have already been deformed, and there is great bone growth on the base of the first phalanx.Coarse -grained grain occurs in places where there is a large voltage of the foot.
Reasons
The main provocative factor for the appearance of a valgus deformation is irregular shoes.When a person wears tight shoes with narrow toes or high toes, the fingers are constantly in the wrong (compressed) position, which contributes to the development of the valgus deformation.However, this is not only the cause of the development of the disease.The following reasons influence the appearance of the pathology:
- traumatic damage to the lower leg and foot;
- Rickets;
- Cerebral palsy;
- Polyneuropathy;
- Low foot of the foot;
- flat feet;
- Congenital weakness of the muscle league apparatus;
- Chronic joint inflammation by psoriasis;
- Arthritis;
- Multiple sclerosis (accompanied by damage to the cover of nerve fibers);
- Diabetes mellitus;
- Gout (deposition of urates in the tissues of the body);
- Hyper of joint mobility that was observed during Marthans and Down syndrome;
- Young foot (fast increase in foot size in the teenage period);
- Charcot-Mari-Tuta disease (hereditary neuropathy, accompanied by the atrophy of the muscles of the distal limbs);
- Osteoporosis (bone loss);
- Stop overload in connection with professional activities (waiter, athlete, ballerinas).
The disease is quick in the presence of provocative factors.
Symptoms
The symptoms of the pathology depend on the degree of damage to the foot.In the first stage, redness, swelling of the tissue in the appearance of the bone, pain in the phalanx of the fingers, which intensifies during walking.In the average stage of development of the disease, pain, swelling, bone growth in the area of the plus bone, dry corn occur under the middle phalanx of the finger.In the heavy level in the sole of the foot and in the thumb, severe, strenuous pain occurs.Dry grains are formed, and under the second and third phalanges of the finger there is a keratization of the skin.
Diagnosis
The diagnostic measures begin to collect the patient's anamnesis.The doctor asks him about disruptive symptoms and is interested in what your appearance causes (leg load, walking, tight shoes).There are metabolic, systemic diseases in medical history, injuries to the lower extremities, hereditary diseases of the bones.Next, an external inspection in which a person is asked to go through.The doctor observes the patient's course and determines the intensity of the pain.The position of the thumb of the foot is examined, its location relative to other fingers, explore the area of its flexion and expansion.The presence of other external symptoms (swelling, redness, thickening of the layer layer under the finger bones) is checked.The footcare of the foot is carried out in three projections in order to identify the degree of deformation of the foot, the transfer of common and related pathologies.An ultrasound of the vessels is carried out to exclude circulatory diseases in the legs.
Treatment
The therapy of the valgus deformation of the foot foot is traditional and operational.In the early stages, if you can do without surgery, doctors recommend choosing more comfortable and correct shoes.You should not like the load on the foot, friction.Comfortable shoes slow the progression of the disease.At the same time, the doctor recommends acquiring special orthopedic devices:
- Seals for the joint bag of the thumb (they eliminate the pressure of the shoes);
- Intodassen rollers, spacers who contribute to the correct distribution of the load on the foot.
All orthopedic devices reduce the pain, but it is impossible to get rid of the discomfort with their help.In order to eliminate pain and inflammation, non -steroid antoiding medication, corticosteroid injections are used.In order to relieve cramps and restore common mobility, massages and special gymnastics are prescribed to relax your feet.
The effectiveness of physiotherapy
Physiotherapy plays an important role in the treatment of valgus deformation.In order to eliminate the disease, the doctors prescribe electrophoresis with calcium, phonophoresis of hydrocortisone, paraffin and ozokerit applications.One of the most effective methods for eliminating the valgus-Deformation of the thumb of the foot is shock wave therapy (UVT).This process implies a short -term effect on the painful zone with acoustic impulses with a low frequency.With the help of UVT, the pain symptoms are eliminated, the effects on the factors that contribute to their appearance are preserved.The process is carried out with a special device that creates the shock waves.They only affect pathological areas without affecting healthy tissue.With the help of ultrasound, metabolic processes improve.UVT is not carried out in the presence of neurological, infectious, oncological, hearty, somatic diseases, diabetes mellitus and blood coagulation disorders.Shock-wave therapy is not prescribed for pregnant women, breastfeeding women and children under the age of 18.The effect of the procedure is observed using several procedures.Pain disappears, it will be easier to run.However, it is impossible to completely remove the protruding bone with a UVT process.The doctor can prescribe at least 5-7 sessions.Depending on the stage of the disease, the procedure for carrying out procedures is also prescribed.Some people are prescribed daily meetings, others will be sufficient for one procedure per week.The result of the treatment of UVT takes place for a long period of time.
Surgical treatment
With an average and severe degree of valgus deformation of the foot tree, surgical treatment is prescribed.In order to eliminate the pathology, many methods were developed by achieving the following goals:
- Elimination of Bursitis of the first foot finger;
- Beating the muscles around the damaged joint to prevent the disease from relapse;
- Perform the reconstruction of the thumb bones.
If the deformation is not expressed strongly, the growth of growth on the joint bag is removed by a small cut.After the operation, one person needs rehabilitation, using the mandatory wearing of an association or shoes with a wooden sole using the correction reader of the foot and physiotherapy (at least 6 methods).The following operations are currently carried out with the Valgus deformation of the thumb:
- Small deformation correction.Small cuts are made on both sides of the thumb through which the position of the midfoot bones and the phalanx of the finger with the help of miniature mills.
- Chevron Oosteotomy.The operation is carried out with a finger deviation of no more than 17 degrees.The growth is cut out and the phalanx of the thumb is attached with a screw and a titanium wire.The structure is removed after a while.
- Schal-Oosteotomy.The operation is carried out if the deviation angle of the thumb is 18-40 degrees.During the intervention, the position of the midfoot bone is corrected and then fixed with two titanium screws.
The protruding bone of the steps is not only aesthetically ugly, but also causes many inconvenience when walking.The disease that the treatment has not ended leads to complications in the work of the entire musculoskeletal system.Therefore, not everything should be approved in one gear and contact an orthopedic