Valgus deformation of the first finger (thumb) is an orthopedic pathology, in which the finger is deformed, deviating.Mainly the disease occurs in women after 30 years.In 3%, Valgus deformation is detected in people aged 15 and 30, in 9% in those who are 31 to 60 and 16% in people over the age of 60.The problem causes not only a strong aesthetic discomfort, but also causes a change in all ligaments, tendons, joints and foot bones.
Pathogenesis
With the Valgus deformation of the first finger, the corner between the first and second bones becomes more, the movement of the first metatarsal bone is observed.The thumb of the foot moves to the outside and the head of the bone protrudes, forming a bone.This bone does not allow the thumb to combine the norm and gradually differs outwards.The tubercle (bone) prevents you from wearing shoes, creates inflammation, friction and leads to the inflammation of the bag of the first metatarsal joint -falangea.Gradually, the bone swells and becomes inflamed, painful.The improper position of the joint causes its premature wear, cartilage injury and an increase in the size of bone growth.This, in turn, causes the trauma of the foot and the further development of the pathology.As the disease advances, 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 arthrosis of the joints of plusplange, inflammation of the joint bags, joints of the fingers, chronic inflammation of the bag of the first metatarsal -falangeo, the displacement of the first metatarsal bone, dishes (chronic and transversal), bones and cartilage in Metatorsal.
Forms
In normal conditions, metatarsal bones are parallel to each other.Under the influence of some reasons, the first metatarsal bone differs and for this reason a small Bump appears on the foot, the ligaments and the tendons lose their elasticity, their dysfunction develops.
The disease passes several phases:
- Soon.At this stage, the diverting of the thumb of the foot is less than 15 degrees.
- Average.The deviation of the first finger on the side ranges from 15 to 20 degrees.At the same time, the deformation of the second finger is observed.It rises above the thumb and becomes like a shape for a hammer.
- Heavy.The diversion of the thumb is 30 degrees.All the fingers of the foot have already been deformed and at the base of the first phalanx there is great bone growth.In places where there is a great tension of the foot, gross corn appear.
Reasons
The main provocative factor in the appearance of Valgus deformation are irregular shoes.If a person wears tight shoes with a narrow tip or high wheels, the fingers are constantly in an incorrect (tablet) position, which contributes to the development of the Valgus deformation.But not only this becomes the cause of the development of the disease.The following reasons affect the appearance of the pathology:
- traumatic damage to the lower part of the leg and foot;
- rickets;
- Cerebral paralysis;
- Poliauropathy;
- low foot arch;
- flat feet;
- congenital weakness of the muscle-legal system;
- Chronic joint inflammation caused by psoriasis;
- arthritis;
- Multiple sclerosis (accompanied by damage to the shell of nerve fibers);
- diabetes mellitus;
- Gout (deposition of undergrounds in the body's tissues);
- Hyper of joint mobility observed during the Marthan and Down syndrome;
- youth foot (rapid increase in the size of the foot in the teenager period);
- Charcot-Mari-Tuta (hereditary neuropathy, accompanied by the atrophy of the muscles of the distal limbs);
- osteoporosis (bone loss);
- Stop the overload in relation to professional activities (waiters, athletes, dancers).
In the presence of provocative factors, the disease progresses quickly.
Symptoms
The symptoms of the pathology depend on the degree of damage to the foot.In the first phase, redness, swelling of the tissues in the appearance of the bone are observed, the pain in the phalanx of the fingers is observed, which intensify during the walk.In the average phase of the development of the disease, pain, swelling, bone growths in the most bone area, dry corn under the average phalanx of the finger.In the heavy phase in the single foot and in the thumb, serious and exhausting pains appear.Dry and the cheratinization of the skin are formed under the second and third phalanges of the fingers.
Diagnostics
The diagnostic measures begin with the collection of the patient's anamnesis.The doctor asks him to disturb symptoms, he is interested in what causes their appearance (full of legs, walks, narrow shoes), there are metabolic and systemic diseases in medical history, inferior ends injuries, hereditary disease diseases.Subsequently, an external inspection is carried out, during which a person is asked to pass.The doctor observes the patient's pace, while determining the intensity of pain.The position of the thumb of the foot is studied, its position compared to other fingers, explores the range of its flexion and extension.The presence of other external symptoms is verified (swelling, redness, thickening of the layer of layer under the bones of the fingers).The foot footography is performed in three projections in order to identify the degree of deformation of the foot, dislocation of joint and correlated pathologies.An ultrasound of ships is carried out to exclude circulatory disorders in the legs.
Treatment
The therapy of the deformation of Vallo del Pollice dello del FoE is traditional and operational.In the early stages, when you can do without surgery, doctors recommend choosing comfortable and correct shoes.The load on the foot should not like, friction.Comfortable shoes slow down the progression of the disease.At the same time, the doctor will recommend buying special orthopedic devices:
- gaskets for the joint bag of the thumb (eliminate the pressure of the shoes);
- Inadassen 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 the discomfort with their help.To eliminate pain and inflammation, non -steering 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 Valgus deformation is played by physiotherapy.To eliminate the disease, doctors prescribe electrophoresis with calcium, hydrocortisone sounds, paraffin and Ozokeritic applications.One of the most effective to eliminateThe deformation of the Foot thumb valgus is the therapy of shock waves (UVT).This procedure implies a short -term effect on the painful area with low frequency acoustic impulses.With the help of UVT, the symptoms of pain are eliminated, the effects on the factors that contribute to their appearance are obtained.The procedure is performed using a special device that generates shock waves.They only affect pathological areas, without affecting healthy tissues.With the help of ultrasounds, metabolic processes improve.UVT is not carried out in the presence of neurological, infectious, oncological, cardiac, somatic, diabetes mellitus diseases, blood coagulation disorders.Shock wave therapy is not prescribed for pregnant women, nursing women and children under the age of 18.The effect of the procedure is observed after several procedures.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 conducting procedures is also prescribed.Some people are prescribed daily sessions, others will be sufficient for a procedure per week.The result of the UVT treatment is held for a long period.
Surgical treatment
With a medium and serious degree of Valgo del Pollice della foot, surgical treatment is prescribed.To eliminate the pathology, many methods have been developed with which they achieve the following objectives:
- eliminate the bursitis of the first finger in the foot;
- Game muscles located around the damaged joint to prevent the impact of the disease;
- Perform the reconstruction of the thumb bones.
If the deformation is not strongly expressed, the growth of growth on the joint bag through a small incision is removed.After the operation, a person needs rehabilitation, with the mandatory use of a bandage or shoes with a wooden sole, using the foot drafts, physiotherapy (at least 6 procedures).Currently, with the deformation of Valgus Del Pollice, the following operations are performed:
- Small correction of the deformation.Small cuts are made on both sides of the thumb, through which, with the help of miniature mills, the position of metatarsal bones and the phalanx of the finger.
- Chevron-oosteotomy.The operation is performed with a deviation of the finger of no more than 17 degrees.The growth is removed and the thumb phalange is fixed with a screw and a thread of titanium.After a while, the structure is removed.
- Scarf-oosteotomy.The operation is performed if the diverting angle of the thumb is 18-40 degrees.During the intervention, using manual exposure, the position of the metatarsal bones is corrected and then fix it with two titanium screws.
The protruding bone of the thumb of the foot is not only aesthetically ugly, but also causes many inconveniences during the walk.The disease that has not finished the treatment leads to complications in the work of the entire musculoskeletal system.Therefore, everything should not be allowed on a march and contact an orthopedist if the first signs of deformation appear