Cause of bunions in the legs (Hallux Valgus)

Correctors indicated for hallux valgus are divided into three types: splints, silicone correctors and special bunion insoles.

Splints can reduce the angle of deviation of the thumb or prevent the development of the disease. In contrast, silicone correctors simply straighten the thumb and separate it from the adjacent one. They also help you live comfortably with a protruding “bone” - they protect it from rubbing with shoes, relieve pain and inflammation. And insoles, coupled with correctors, help correct not only hallux valgus, but also the cause of the disease - longitudinal or transverse flatfoot.

The choice of correctors is a very individual procedure. Just because a particular product quickly solved your great aunt's problem doesn't mean it will work just as well for you.

Question 2: When and where are you ready to wear concealers?

If you are results-oriented and want to wear correctors around the clock, then one single model will not be enough for you. Some correctors fit perfectly in shoes, others do not even fall off bare feet, and others do not fit anywhere except house slippers. Products will have to be changed depending on your activity and location, for example: at home - articulated splints, at work - thin fabric splints, while sleeping - a night bandage.

How to choose correctors that are suitable specifically for your case and will be convenient for your lifestyle? Let's find out!

Orthopedic bandage for thumb

No adverse reactions have been described when using the bandage. It is shown even to children. According to the results of many years of observations, the correct choice and regular use of an orthosis gives a positive dynamics of 100%. The bandage simultaneously solves several problems:

• reduces pain by evenly distributing weight and other stress on the joints;
• reduces the inflammatory response;
• prevents the development of bursitis, calluses, corns, poor circulation, loss of elasticity of muscles and ligaments.

The clamps give the deviated finger the correct anatomical direction and significantly reduce the size of the existing bump. With a slight deviation angle, the valgus curvature will gradually disappear. In severe, advanced stages, the protruding bone may decrease, and the condition of the joint will also improve: the intensity of pain and inflammation, if there was any, will decrease.

Wearing an orthosis has a number of tangible benefits:

• no irritation or allergic reactions due to hypoallergenic materials;
• easy care - clean the silicone corrector with wet wipes, manually clean the fabric one;
• high probability of correcting the first signs of planovalgus deformity with adjustable clamps;
• affordable price and durability.

Bursoprotectors

Description

Bursoprotectors are similar in functionality to silicone retainers. Their main difference is the presence of a ring on the second finger. The second ring has 2 advantages:

• Hammer toe protection;
• Better fixation on the leg without the need to wear shoes so that the corrector does not fall off.

The underwire cap is narrow compared to the brace, which means it is suitable for smaller women's legs. However, the “petal” fits very tightly to the skin and does not move or stick out.

Alternative

• Fabric overlays for fingers in the form of covers . They have a small thickness of material, so they weakly separate the fingers from each other. They can prevent the formation of calluses and corns, but they will not correct the deformity.
• Orthopedic insoles do not fit all shoes, and they cannot be worn with sandals at all. As a result, the patient is forced to sweat in closed shoes all summer or interrupt the correction of the deformity.
• Bursoprotector is a device in the form of a ring that fits on the big toe and covers half of the foot on the side of the affected joint. Due to its large size, the device does not fit with every shoe.
• Pelot is a silicone device placed under the fingers to eliminate their hammer-like deformation. Corrects the shape of the phalanges, but does not remove the bone.

Fabric bandage with silicone pad on the bone

Description

Silicone correctors can consist entirely of medical silicone, but can also have a fabric base. A silicone and spandex bandage is an excellent alternative to silicone correctors. It fits on your foot like a sock. A silicone pad is hidden under the fabric in the area of ​​the thumb bone. The dimensions of the overlay allow it to cover extensive inflammation. And the separator between the thumb and second finger prevents them from crossing. It is ideal if your skin sweats or breaks out in a rash when it comes into contact with silicone. If you just don't like silicone and prefer fabric, this bandage is for you too.

Insoles are the simplest and most convenient way to treat hallux valgus. If you can put on and take off correctors in no time, then you don’t have to bother with insoles at all. It is enough to remove the “original” insole from the shoe once, insert the orthopedic one inside - and you’re done!

Surgery

If all conservative measures are not effective, then a decision is made on surgical treatment. Currently, there are more than 100 surgical techniques for the treatment of Hallus valgus. The main tasks in surgical treatment are as follows:

• remove bunion
• reconstruct the bones that make up the big toe
• balance the muscles around the joint so that there is no recurrence of the deformity

Removing the “growth”

In some mild cases of bunion formation, only the growth on the joint capsule may be removed during surgery. This operation is performed through a small incision on the side of the foot in the area of ​​the bunion. Once the skin is cut, the growth is removed using a special surgical chisel. The bone is aligned and the skin incision is closed with small sutures.

It is more likely that reconstruction of the big toe will also be necessary. The main decision that must be made is whether the metatarsal bone needs to be cut and also reconstructed. To resolve this issue, the angle between the first metatarsal and the second bone is important. The normal angle is approximately nine or ten degrees. If the angle is 13 degrees or greater, the metatarsal bone will most likely need to be cut and reconstructed. When the surgeon cuts and repositions the bone, it is called an osteotomy. There are two main techniques used to perform osteotomy and reconstruction of the first metatarsal bone.

Distal Osteotomy

In some cases, the distal end of the bone is cut and moved laterally (this is called a distal osteotomy). This effectively reduces the angle between the first and second metatarsals. This type of surgery usually requires one or two small incisions in the leg. Once the surgeon has achieved satisfactory bone alignment, the osteotomy is followed by fixation of the bones using metal pins. After surgery and healing, the pins are removed (usually they are removed 3-6 weeks after surgery).

Procymal osteotomy

In other situations, the first metatarsal bone is cut at the proximal end of the bone. This type of surgery usually requires two or three small incisions in the leg. Once the skin is cut, the surgeon performs an osteotomy. The bone undergoes reconstruction and is temporarily fixed with metal pins. This operation also reduces the angle between the metatarsal bones. In addition, the tendon of the adductor big toe muscle is released. Therefore, after the operation, a special bandage is put on.

Rehabilitation after surgery

It takes an average of 8 weeks for the soft tissue and bones to heal. During this period, it is better to place the foot in shoes with a wooden sole or a special bandage in order to prevent trauma to the operated tissues and allow normal regeneration. Immediately after surgery you may need crutches.

In patients with severe bursitis, physiotherapy (up to 6-7 procedures) may be prescribed a certain time after surgery. In addition, you must wear shoes with wide fronts. It is also possible to use correctors. All this can allow you to quickly return to normal walking.

Transverse flatfoot and bunion - where is the connection?

Let's figure out how insoles for transverse flat feet can be associated with hallux valgus. When walking, normal feet rest on the joints of the 1st and 5th toes, forming an “arch.” With transverse flatfoot, the arch seems to “sag” and the load moves to the middle joints. But they are not naturally designed for such a load.

When wearing underwire insoles, the rigid frame in combination with the bolster lifts the outer joints of the toes and forces the transverse arch of the foot to rest on them. The foot muscles begin to reflexively lean on the places where support is felt. Thus, a correction occurs - the foot “gets used” to resting on the joints of the big toe and little toe.

What shoes to wear with?

These insoles are suitable for sports and casual shoes with closed heel and toe.

Who are the insoles for?

The insoles are suitable for those who, along with hallux valgus, also have transverse flat feet.

Correctors will cope better with the task if used in combination with other products. An integrated approach includes the use of anti-inflammatory cream along with silicone correctors and shoe expanders, which help to “fit” shoes to the bone.

Causes of hallux valgus deformity

There are many reasons for the development of foot valgus. The main ones:

• genetic predisposition transmitted through the female line;
• osteoporosis;
• weakness of the muscular-ligamentous apparatus;
• injuries (bone fractures, sprained ligaments);
• long-term immobilization of the joint in a plaster cast;
• joint diseases (arthritis, arthrosis);
• being on your feet all day, which is associated with the profession;
• excess weight;
• incorrect shoes with narrow toes and high heels.

Significant excess body weight and shoes with heels higher than 10 cm cause over time, in addition to foot deformation, an X-shaped curvature of the legs, which will be called knee valgus. It develops in both children and adults (more often in old age).

Shoe extenders for bunions

It is difficult for someone with large bunions to choose suitable shoes, because manufacturers do not produce models designed for feet with bunions. New shoes have to be worn in for a long time and painfully until the walls of the shoes stretch as required. The shoes are tight, the inflamed joints hurt, and the correctors do not fit into the already narrow new shoes.

To solve this problem, special expanders have been invented. They are inserted into the toe part of the shoe and, like lasts, expand it.

Instructions for use

Before you begin treating valgus with a bandage, you need to carefully study the instructions included with the orthosis. It contains detailed rules for using the fixative.

Indications

Wearing a bandage is indicated primarily for curvature of the first toe with subsequent restriction of movements in this joint. The likelihood of restoring the normal shape of the leg depends on the stage of the process and the reasons that caused the pathological changes.

In addition, wearing an orthosis is recommended:

• with flat feet;
• for joint diseases;
• with hammertoes (joints of 2-5 fingers are curved upward).

Removal of an ingrown toenail - description and types of surgical removal surgery

Surgical treatment is aimed at excision of the edge of the nail or total removal of the nail plate. Granulation tissue can also be eliminated. The duration of this operation is 20-30 minutes. To make the patient feel comfortable, local anesthesia is used. After completion of the surgical stage, a bandage is applied to the wound.

Surgical methods of correction:

• Traditional removal with a scalpel, which is less preferable but more affordable;
• Radio wave method, which allows you to shorten the duration of the intervention and reduce blood loss;
• Using a laser. In this way, selectivity of action is achieved, only affected tissues are removed, healthy ones remain undamaged, and a powerful bactericidal effect is ensured. This method is the most promising because it minimizes the risk of relapse.

Complications of an ingrown toenail

This disease is most characterized by complications such as persistent deformation of the nail plate and the transition of the process to a chronic form, when granulations are formed, and a purulent-inflammatory process in the tissues periodically develops. In this case, the patient feels constant pain, which intensifies when walking. After removal of the nail plate and quality rehabilitation measures, the inflammatory process will be completely stopped.

Without proper treatment, the consequences of an ingrown toenail can be even more severe:

• inflammation of the soft tissues of the entire finger with the development of panaritium, abscess;
• involvement of bone structures in the pathological process, osteomyelitis;
• gangrene of the finger, the only possible treatment for which is amputation;
• due to the presence of an area of ​​constant trauma, there are prerequisites for the formation of fibromas and malignant tumors.

Prevention

Dealing with an ingrown toenail is not easy, and often even the treatment itself brings discomfort. Also, in some cases, even after effective treatment, the disease constantly returns. We have to fight relapses with the help of preventive measures.

Prevention of ingrown toenails includes the following nuances:

• It is necessary to regularly and most importantly trim your nails correctly.
  You should not cut off the corners of the nail too much, giving it a rounded shape. This injures the skin and also causes impaired nail growth. Pedicure salons are usually aware of this feature.
• Do not cut your nails to the root
  . When shoe pressure is applied, nail growth is disrupted. If the free edge protrudes slightly, the likelihood that the nail will begin to grow in is reduced.
• Choose the right shoes
  . It should be comfortable, fit and breathable. If your foot sweats a lot, it is better to choose other shoes or avoid synthetics (socks, nylon tights). It is important that the shoes do not press, do not rub your fingers, and do not have high heels that interfere with blood circulation.
• If there is a chance of injuring your toes, you need to remember safety precautions, wear protective equipment
  and special shoes that will protect your toes from impacts.
• The fungal infection
  needs to . You cannot wear someone else's shoes, and you must always have rubber slippers with you in the pool.
• If you have flat feet,
  you need to pay special attention to your feet.
  It is advisable to use orthopedic insoles
  and also do foot massage.
• You need to avoid shoes with narrow toes.
  Even if it seems comfortable, this style of shoe squeezes your toes.

If you have diabetes, the likelihood of ingrown toenails is higher, so you need to regularly examine your feet and consult a doctor when the first symptoms appear.

Also, do not forget about preventive examinations. If there is a predisposition to onychocryptosis, you need to carefully monitor the occurrence of pain and discomfort.

Treatment of ingrown toenails

Before

After

Reviews

The services of a podiatrist play a vital role in the correction of ingrown toenails. It is within his competence to determine all the provoking factors, as well as to ensure proper growth of the nail plate through orthopedic manipulations. Since the professional qualities of the doctor are of paramount importance to obtain the desired result of non-surgical correction, patient reviews will be indispensable. Comments can be obtained through word of mouth or by going to the forum.

If you are interested in these medical services, please contact Mikulo Natalya Valerievna. This is exactly the advice given by patients who have undergone the appropriate correction. A wide range of effective techniques, an individual approach in each case, and attentive attitude are the main characteristics of a doctor’s work. That is why the Internet is full of positive reviews about her work.

Price

The price of treatment for an ingrown toenail in Moscow is determined by the measures taken. The use of conservative approaches will be more affordable than performing surgery using modern technologies, radio wave method or laser. Considering that surgical intervention requires a recovery period and is accompanied by pain, it is more justified to use the services of a podiatrist and pay attention to preventive measures. This will cost significantly less and is not associated with the risk of developing postoperative complications.

What type of bandage is there?

Criteria by which orthoses for the first toe are classified:

• preferred time of day when you need to wear the bandage (daytime, nighttime);
• materials from which the devices are made (plastic, silicone, thick fabric, combinations thereof);
• design: articulated (large, small, with pad), simple.

Existing versions of orthosis models are conventionally divided into 3 types:

1. Fixing (for daily use) - do not have a therapeutic effect, but relieve symptoms such as leg pain and discomfort when walking. The clamps are simple in design and therefore inexpensive. They have one drawback - unregulated voltage. Therefore, to increase or decrease the impact on the finger, you will need to purchase a new bandage.
2. Abductor night frame - treats the disease. The result appears after the first sessions of its use. The design, worn in the evening, should fix the leg until the morning. Bandages with a movable splint and fastener are used: the foot feels comfortable in them, and the results appear faster.
3. Correctors are needed for postoperative rehabilitation. They do not treat changes in the foot, but do not allow them to progress (silicone or plastic are used). When worn, they remain invisible: they are comfortable to wear in sandals throughout the day.