Valgus deformation of the first (thumb) finger is an orthopedic pathology in which the finger is deformed, deviating.Most of all, the disease is found in women after 30 years.In 3% Valgus deformation is found in people aged 15 to 30 years, in 9% in those from 31 to 60, and 16% in people over 60 years.The problem not only causes a strong aesthetic discomfort, but also provokes a change in all connections, tendons, joints and bones of the foot.
Pathogenesis
With the deformation of the valgus of the first finger, the angle between the first and second bones becomes more plus, there is a displacement of the first metatarsal bone.The finger of the foot is shifted out and the bone head protrudes, forming a bone.This bone does not allow the thumb to match the norm and gradually deviates outwards.Tuberculosis (bone) prevents you from wearing shoes, creates inflammation, rubbing and leads to inflammation of the bag of the first metarsophalangeal joint.Gradually the bone swells and becomes inflamed, painfully.The wrong position of the joint provokes its premature wear, the cartilage lesion and an increase in the size of bone growth.This, in turn, provokes the trauma of the foot and the more increasing development of the pathology.As the disease progresses, the thumb shifts the remaining toes of the foot, leading to their deformation in the form of a hammer.While the disease develops, it leads to arthrosis of plusnoplange joints, inflammation of the joints, joints of the fingers, chronic inflammation of the bag of the first metarsophalangeal joint, shift of the first metatarsal bone, flat pediatric (chronic and transverse), bones and cartoon augentum augentum MEATATUMATUMATUMATUATum METATum METATUMATUMATUMATUMATUMATUMATUMATUMATUMATUMATUMMATUMEMATUMATUMEMATUMMATUMEMATUM.
Forms
In the normal state, the bones of metatarsis are parallel to each other.Under the influence of certain causes, the first metatarsal bone deviates and therefore a small boom appears on the foot, the ties and tendons lose their elasticity, their dysfunction develops.
The disease passes several stages:
- Early.At this stage, the deviation of the thumb of the foot is less than 15 degrees.
- On average.The first finger deviation is from 15 to 20 degrees.At the same time, deformation of the second finger is observed.It rises above the thumb and becomes like a hammer.
- Heavy.The thumb deviation is 30 degrees.All toes of the foot are already deformed, and at the base of the first phalanx there is a large bone growth.Gross calluses appear in places where there is a lot of tension.
Reasons
The main provocative factor for the appearance of deformation of Valgus is irregular shoes.If a person wears tight shoes with a narrow finger or tall, then the fingers are constantly in the wrong (compressed) position, which contributes to the development of deformation of Valgus.But not only does this become the cause of the disease.The following causes affect the appearance of pathology:
- traumatic damage to the lower legs and foot;
- rickets;
- Cerebral palsy;
- Polyneuropathy;
- low foot arch;
- flat legs;
- congenital weakness of the musculoskeletal apparatus;
- Chronic inflammation of the joints provoked by psoriasis;
- arthritis;
- multiple sclerosis (accompanied by damage to the nerve fiber sheath);
- Diabetes sugar;
- gout (deposition of urate in the tissues of the body);
- Hyper of joint mobility observed during Martans and Down Syndrome;
- Youth leg (rapid increase in foot size during the teenager);
- Charcot-Mari-Tuta disease (hereditary neuropathy accompanied by atrophy of the distal limbs muscles);
- osteoporosis (bone loss);
- Stop the overdone in connection with professional activities (waiters, athletes, ballerinas).
In the presence of provocative factors, the disease progresses rapidly.
Symptoms
The symptoms of the pathology depends on the degree of damage to the foot.In the first stage, redness is observed, swelling of the tissues as bone appearance, pain in the phalanx of the fingers, increases during walking.In the middle stage of the development of the disease, pain, swelling, bone growth in the area of the plus bone, dry corn under the middle phalanx of the finger.In the heavy stage, severe, exhausting pain appears in the sole of the foot and in the thumb.Dry corn and keratinization of the skin are formed under the second and third phalanges of the fingers.
Diagnostics
Diagnostic measures begin with the collection of the patient's history.The doctor asks him for disturbing symptoms, is interested in what provokes their appearance (loading of the legs, walking, tight shoes), in medical history there are metabolic, systemic diseases, injuries to the lower limbs, hereditary bone diseases.An external inspection is then carried out, during which a person is asked to pass.The doctor monitors the patient's gait, while determining the intensity of pain.The position of the thumb of the foot is examined, its location relative to other toes, examines the range of its bending and expansion.The presence of other external symptoms (swelling, redness, thickening of the layer under the bones of the fingers) has been checked.The photonography of the foot is performed in three projects to identify the degree of deformation of the foot, the dislocation of the joints and the associated pathologies.Ultrasound of the vessels is performed to exclude blood disorders in the legs.
Treatment
Valgus therapy deformation of the thumb of the foot is traditional and active.In the early stages, when you can do without surgery, doctors advise to choose comfortable and right shoes.It should not please 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:
- seals for the joint bag of the thumb (they eliminate the pressure of the shoes);
- Intodassen rollers, spacers who contribute to the proper distribution of the load of the foot.
All orthopedic devices reduce pain, but it is impossible to completely get rid of the discomfort of their help.Non -steroidal anti -inflammatory drugs, corticosteroid injections are used to eliminate pain and inflammation.In order to relieve spasms and restore the mobility of the joint, massage and special gymnastics are prescribed to relax the legs.
The effectiveness of physiotherapy
An important role in the treatment of Valgus deformity is played through physiotherapy.To eliminate the disease, doctors prescribe electrophoresis with calcium, phonophoresis of hydrocortisone, paraffin and ozoket applications.One of the most effective methodes forElimination of Valgus deformation of the thumb of the foot is shock wave therapy (UVT).This procedure involves a short -term effect on the painful area with acoustic low frequency pulses.UVT eliminates the symptoms of pain, produce the effects on the factors that contribute to their appearance.The procedure is performed with the help of special impact waves.They only affect pathological areas without affecting healthy tissues.Ultrasound, metabolic processes improve.UVT does not take place in the presence of neurological, infectious, oncological, cardiac, somatic diseases, diabetes mellitus, disorders of blood coagulation.Impact wave therapy is not prescribed for pregnant women, nurses and children under 18 years of age.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 protruding bone using a UVT procedure.The doctor may prescribe at least 5-7 sessions.Depending on the stage of the disease, the procedure for procedures is also prescribed.Some people are prescribed daily sessions, others will be sufficient for one procedure a week.The result of UVT treatment is carried out for a long period.
Surgical treatment
With An Average and Sevee Degree of Valgus Deformation of the Thumb of the Foot, Surgical Treatment Is Prescribed.In order to eliminate the pathology, many methods have been developed through which they achieve the following goals:
- Eliminate bursitis on the first toe;
- Bowing Muscles Located Around the Damaged Joint to Prevent Relapse of the Disease;
- Make the reconstruction of the bones of the thumb.
If the deformation is not strongly pronounced, the growth of growth on the bag with the joints by a small incision is removed.After surgery, one needs rehabilitation, such as the mandatory wearing of a dressing or shoes with a wooden sole, using foot concealed, physiotherapy (at least 6 procedures).The following operations are currently being performed with the deficiency of Valgus of the thumb:
- Correction of small deformation.On both sides of the thumb, small cuts are made through which with the help of miniature mills the position of the metatarsal bones and the phalanx of the finger.
- Chevron-Osteotomy.The operation is performed with a finger deflection of no more than 17 degrees.The growth is cut and the phalanx of the thumb is fixed with a screw and titanium wire. After a while, the structure is removed.
- Scarf osteotomy.The operation is performed if the angle of thumb deviation is 18-40 degrees.During the intervention, using manual exposure, the position of the metatarsal bones is adjusted and then secure it with two titanium screws.
The protruding bone of the thumb of the foot is not only aesthetically ugly, but also causes a lot of discomfort when walking.The Disease That has not finished Treating Leads to Complications in the Work of the Entire Musculoskeletal System.Therefore, everything should not be allowed to gear and contact orthopedic if the first signs of deformation appear