Description of the disease
Operation Hallux Valgus or treatment of hallux valgus is one of the priority tasks of surgery.
Today this is the most common orthopedic pathology. Of all patients, it affects 80% of women and 20% of men. Regular pain in the legs and aesthetic defects significantly complicate life for patients with a curvature of the joint in the big toe area. A mild degree of the defect looks like a small protruding bone near the big toe; in severe cases, the degraded joint causes a lot of trouble for its owner. Problems vary from excessive leg fatigue to the inability to find shoes.
Fortunately, the pathology can be corrected. The Ladisten Clinic performs minimally invasive surgeries using modern technologies. As a result, the patient forever forgets the diagnosis of hallux valgus, and his legs live a full life.
What is hallux valgus?
Valgus deformity (Hallux Valgus or bunion on the side of the foot)
is a change in the metatarsophalangeal joint of the big toe.
Under the influence of various factors, it deviates to the side, the articular and connective tissues grow, and a painful lump forms at the base of the big toe.
The problem can occur on one leg, sometimes on both legs in parallel.
Modern medicine offers several methods for removing a bunion, among which experts consider the classic method to be the most progressive and safe.
Methods of surgical treatment of hallux valgus
The most effective way to eliminate a bunion on the big toe is surgery. Pit removal is performed using the following methods:
- Percutaneous foot surgery. A minimally invasive operation during which it is possible to completely remove the bone through small incisions. Micro-instruments are inserted under the skin to allow correction with minimal discomfort. The procedure is performed under X-ray control and without osteosynthesis. This approach can significantly shorten the rehabilitation period and completely eliminate hallux valgus.
- Laser resurfacing. A minimally invasive intervention that allows you to get rid of the bone near the big toe in the early stages of its development. Using a special apparatus, layer-by-layer removal of pathological tissue is carried out. Thanks to the use of a laser beam, it is possible to achieve disinfection and rapid healing of the wound. The recovery period for this operation is the shortest. You are allowed to walk the very next day.
- Reconstruction of the forefoot. A serious intervention that is used for advanced hallux valgus deformity. Performed in an open manner. The soft tissue is dissected, the thumb axis is realigned, and growths are removed. After fixing the bone, sutures and a sterile dressing are applied.
The doctor determines what type of surgery to correct hallux valgus to use individually for each patient.
Factors that increase the risk of developing Hallux Valgus
Internal factors
- heredity
- ligamentous weakness
- joint diseases
- transverse flatfoot
- neurological disorders
- endocrine system problems
External factors
- shoes with too narrow toes
- high heel shoes
- overweight
Women suffer from Hallux Valgus 10 times more often than men due to the characteristics of the endocrine system and addiction to uncomfortable shoes with narrow toes and too high heels
Symptoms and stages
Treatment options
CONSERVATIVE TREATMENT
At stage 1
the disease is successfully treated with conservative methods, using physiotherapy.
Also, the patient is recommended to moderate physical activity, normalize weight, and wear orthopedic shoes, or, as an option, just comfortable shoes, using pads and foot pads that relieve the load on the problem joint.
SURGICAL TREATMENT
Disease at stages 2 and 3
can only be treated surgically.
During the operation, the orthopedic surgeon removes excess bone and joint tissue and removes the deformity of the first metatarsal bone - the patient is completely and forever rid of the problem.
The duration of the operation is 1 hour.
Soft tissue operations
Operation Silver
The essence of the technique is cutting off the tendon of the adductor muscle of the big toe. As a rule, it is one of the stages of combined techniques.
Operation McBride
The adductor tendon is not simply cut off, but transferred. Quite often combined with Shede's operation.
The illustration shows the creation of a “tunnel” through the metatarsal head and the passage of the adductor tendon through it. In various modifications of McBride, the tendon can be sutured to the capsule and head of the metatarsal bone, or fixed on the back of the head. The modifications have the same goal: to reduce the angle between the metatarsals.
Operation Mann (RA Mann)
Distal soft tissue procedure. It is currently an integral part of many combined operations. The goal of the procedure is to restore the position of the sesamoid bones in the thumb area.
Sesamoid bones are displaced laterally during valgus deformity. Returning them to their previous anatomical position is carried out by cutting off the tendon of the adductor pollicis muscle from the lateral sesamoid bone, excision of the lateral collateral ligament, making releasing incisions on the outer surface of the joint capsule and intersection of the metatarsesamoid ligament. It can be performed through an arthroscope. In this case, the traumatic nature of the operation is significantly reduced.
When is laser removal of a bunion on the foot performed?
Hallux valgus most often affects women over the age of 30. One specific reason for the development of this pathology has not yet been established, but experts give the leading role to hereditary and hormonal factors. Also, the formation of bunions can be affected by wearing uncomfortable high-heeled shoes, excess weight, a history of osteoporosis, injuries and damage to the foot.
You should contact a specialist immediately if a protruding bone appears on the side of the foot. At the initial stages of pathology development, the doctor will most likely offer conservative treatment in the form of massages, physiotherapy, wearing orthopedic shoes and taking medications. The operation is performed in cases where the patient notes the following symptoms:
- pain when walking and at rest;
- the angle of deviation of the phalanx of the big toe is more than 30°, displacement of the remaining toes is observed;
- swelling of the feet and the development of an inflammatory process in the surrounding tissues with the formation of ulcers and purulent skin lesions;
- inability to choose comfortable shoes due to a very protruding bone;
- gait disturbance accompanied by spinal curvature.
Practice shows that timely removal of a bunion significantly improves the patient’s quality of life, eliminates pain, prevents spinal deformities and severe joint diseases.
Advantages of treatment for hallux valgus in our clinic
If you notice the appearance of a bone near your thumb, do not delay contacting a specialist. At the Center for Foot and Ankle Surgery in Moscow, you can undergo an examination using modern equipment. We have experienced orthopedic doctors who will accurately determine the degree of deformation and select the optimal treatment method.
To remove bunions on the legs, we try to use minimally invasive interventions to ensure a painless and quick recovery period. Correctly selected treatment can completely eliminate hallux valgus and return you to the joy of movement.
You can make an appointment with an orthopedist at the Foot Surgery Center in Moscow by phone or on the website.
Preparing to remove a bunion
Before removal of hallux valgus, the patient undergoes a comprehensive examination, including the following diagnostic procedures:
- examination by an orthopedist;
- conducting a general blood and urine test;
- X-ray of the foot;
- biochemical analysis
- analysis for coagulation and infections of HIV, Syphilis, Hepatitis B and C,
- ECG and therapist's report,
- cardiologist's report,
- magnetic resonance or computed tomography (if indicated),
- Doppler ultrasound of the veins of the lower extremities
The first 2 weeks after corrective osteotomy of Hallux Valgus.
In most cases, the patient stays in the clinic for 2-3 days until the acute pain syndrome is relieved, after which he is discharged for outpatient follow-up treatment. It is advisable to perform dressings once every 2 days, removing sutures on the 14th day after surgery. It is possible to use intradermal sutures at the request of the patient, this eliminates the need to remove them. In order to reduce pain and postoperative swelling, all patients are recommended to elevate the lower extremities and use local cold for 30 minutes every 4 hours during the first two weeks after surgery.
Swelling and postoperative hematomas usually increase within 3 days after surgery, after which they gradually regress over 6 weeks. Appearance of the feet on the 5th day after surgery (the most pronounced swelling and hematomas).
How is the operation to remove hallux valgus performed?
The operation can be performed under spinal anesthesia, intravenous anesthesia and general anesthesia. The type of anesthesia is determined by a specialist in accordance with the individual characteristics of the patient’s condition. Also, based on the X-ray data, the specialist determines the procedure for performing the operation. Most often, removal is carried out using the following methods:
- Exostectomy - this method is used most often and is considered a priority method for treating hallux valgus without complications and additional pathologies. The operation is carried out in several stages. The doctor makes careful incisions in the soft tissue to gain access to the overgrown joint and bone tissue. Next, the bones are removed layer by layer until the normal shape and size of the metatarsophalangeal joint is achieved. This allows you to carefully remove the growth while maintaining the integrity and mobility of the joint.
- Osteotomy - this technique is used in cases of advanced deformity and significant curvature of the big toe against the background of hallux valgus. In this case, part of the phalanx of the big toe is removed along with the growth. The patient partially loses the mobility of the toe, but this makes it possible to restore the correct shape of the other toes and eliminate the symptoms of the pathology.
- Resection arthroplasty is the most radical technique, which is indicated in case of damage to the joint itself by overgrown tissue. During resection arthroplasty, the damaged joint is completely removed and replaced with a prosthesis, which can be made of metal, composite or other biocompatible material.
The correction provides patients with:
- beautiful feet without protruding “bones”;
- absence of excruciating pain;
- lifelong effect without relapse with properly selected shoes and favorable rehabilitation;
- rapid restoration of motor activity and performance.
It is important to understand that a bunion is not only an aesthetic defect, but also a serious problem that increases the risk of disability. Timely correction protects physical and psychological health.
Treatment of deformity of the joint of the big toe with surgery is 98% effective.
If conservative methods do not have the desired effect for a long time, you should consult an orthopedist and think about surgical intervention.
Prevention of recurrent hallux valgus deformity
After removal of a bone on the leg, relapse of the pathology develops extremely rarely. To avoid the return of foot health problems, you should be attentive to the condition of your limbs, wear comfortable shoes and avoid overwork.
For overweight patients, it is very important to normalize body weight to reduce the load on the legs. Women should closely monitor their hormonal levels and regularly visit a gynecologist, since endocrine disorders also lead to the development of hallux valgus.