The deformation of the first finger valgus (thumb) is an orthopedic pathology, in which the finger is defective, deviating.Most diseases occur in women after 30 years.In 3%, valgus deformation is detected in people ages 15 to 30, in 9% in those ages 31 to 60, and 16% in people over 60.The problem causes not only strong aesthetic discomfort, but also causes changes in all ligaments, tendons, joints, and bones.
Pathogenesis
With the deformation of the first finger valgus, the angle between the first and the second bone becomes increased, the first metatarsal bone transition is observed.The foot of the foot shifts to the outside, and the bone head is attached, forming the bone.These bones do not allow the thumb to match the norm, and gradually deviate outside.Tubercle (bone) prevents you wearing shoes, creating inflammation, friction and causing inflammation of the first metatarsophalangeal joint bag.Gradually, the bones swell and become inflamed, painful.Improper positioning of the joints provoking premature wear, cartilage wounds and increased bone growth size.This, in turn, causes foot trauma and further pathological development.As the disease progresses, the thumb removes the remaining toes, leading to their deformation in the form of a hammer.As the disease develops, it leads to plusplange joint arthrosis, inflammation of the articular bag, finger joints, chronic inflammation of the first metatarsophalangeal joint, first metatarsal bone removal.
Form
Under normal circumstances, metatarsal bones are parallel to each other.Under the influence of certain causes, the first metatarsal bone deviates and because of this, small bumps appear in the feet, ligaments and tendons lose their elasticity, their dysfunction develops.
The disease passes through several stages:
- Early.At this stage, the thumb deviation is less than 15 degrees.
- Average.The first finger to the side is from 15 to 20 degrees.At the same time, the second finger deformation is observed.It rises on the thumb and becomes like a shape to the hammer.
- Heavy.The thumb deviation is 30 degrees.All the toes were defective, and at the first phalanx there was a large bone growth.In places where there is a large foot voltage, a coarse corn appears.
Cause
The main factor that creates the appearance of valgus deformation is irregular shoes.If a person wears tight shoes with narrow or high feet, then the finger is always in the wrong (compressed) position, which contributes to the development of valgus deformation.But not only is this the cause of the development of the disease.The following causes affect the appearance of pathology:
- traumatic damage to the lower leg and feet;
- ricket;
- Cerebral palsy;
- Polyneuropathy;
- low leg gateway;
- flat feet;
- congenital weakness of muscle-ligaments;
- Chronic joint inflammation provoked by psoriasis;
- arthritis;
- various sclerosis (accompanied by damage to nerve fiber shells);
- Diabetes mellitus;
- gout (deposition of veins in body tissue);
- Hyper of shared mobility observed during Marthans and Down Syndrome;
- young feet (rapid increase in foot size during adolescence);
- Charcot-Mari-Tuta disease (hereditary neuropathy, accompanied by distal distal muscles atrophy);
- osteoporosis (bone loss);
- Stop overstrain related to professional activities (servers, athletes, ballerinas).
With the presence of provocative factors, the disease develops rapidly.
Symptom
Pathological symptoms 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 finger phalanx, increasing during walking.At the average stage of disease progression, pain, swelling, bone growth in the bone area, dry corn under the middle phalanx of the finger appears.At the heavy stage at one leg and in the thumb, severe pain, tiring.Dry corn is formed, and skin keratinization appears under the second and third fingers.
Diagnostics
The diagnostic steps begin with the accumulation of patient anamnesis.Doctors asked him about disturbing symptoms, interested in what caused their appearance (foot load, walking, narrow shoes), there was metabolic, systemic disease in medical history, lower leg injury, bone disease.Next, an external examination is conducted, where one is asked to go.The doctor watches the patient's style, while determining the intensity of the pain.The position of the toe is learned, the location relative to the other fingers, exploring the various flexion and extension.The presence of other external symptoms (swelling, redness, thickening of the layer under the finger bone) is examined.Foot footenography is performed in three projections to identify the level of foot deformation, joint and related pathological disorders.Ultrasound vessels are carried out to exclude circulatory disorders in the foot.
Treatment
Valgus deformation therapy from the toes is traditional and operating.In the early stages, when you can do without surgery, the doctor advises choosing simple and right shoes.He cannot delight the load on the feet, friction.Comfortable shoes slow down the development of the disease.At the same time, the doctor will advise you to buy a special orthopedic device:
- gaskets for bags with thumb (they eliminate shoe pressure);
- Intodassen roller, a spacer that contributes to the proper distribution of loads on the feet.
All orthopedic devices reduce pain, but it is impossible to eliminate discomfort with their help.To eliminate pain and inflammation, anti -nonsteroids, corticosteroid injections are used.To relieve cramps and restore joint mobility, special massage and gymnastics are set to rest 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 phonophyesis, paraffin and ozokokitic applications.One of the most outstanding to eliminate changeThe shape of the toe valgus is a shock wave therapy (UVT).This procedure shows a short effect on the painful zone with acoustic low pulse.With the help of UVT, the symptoms of pain are eliminated, the effects of the factors contributing to their appearance are obtained.This procedure is performed using a special device that generates shock waves.They only affect the pathological area, without affecting healthy tissue.With the help of ultrasound, the metabolic process improves.UVT is not performed in the presence of neurological, infectious, oncology, heart, somatic, diabetes mellitus, blood clotting 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.The pain is gone, it becomes easier to walk.But it is impossible to get rid of prominent bones by using a UVT procedure.The doctor can prescribe at least 5-7 sessions.Depending on the level of the disease, the procedure for performing the procedure is also prescribed.Some people are prescribed daily sessions, others will be sufficient for one procedure per week.UVT treatment results are held for a long time.
Surgical
With the level of average and severe valgus deformation from the toes, surgical treatment is prescribed.To eliminate pathology, many methods have been developed by which they achieve the following goals:
- removes the first bursitis of the foot;
- Muscle bowing located around damaged joints to prevent relapse of the disease;
- Carry out the reconstruction of the thumb bone.
If the deformation is not stated strongly, the growth of the joint bag through a small slice is removed.After surgery, one needs recovery, wearing a bandage or shoe with one wood, using proof readers, physiotherapy (at least 6 procedures).Currently, with the deformation of the thumb valgus, the following operation is performed:
- Small deformation correction.Small pieces are made on both sides of the thumb, where, with the help of a small factory, the position of the metatarsal bone and the finger phalanx.
- Chevron-oosteotomy.This operation is performed with a finger deviation of no more than 17 degrees.This growth is released, and the thumb phalanx is set with screws and titanium wires.After a while, the structure is removed.
- Scarf-oosteotomy.This operation is carried out if the angle of thumb deviation is 18-40 degrees.During intervention, using manual exposure, metatarsal bone position was corrected, and then fixed it with two titanium screws.
The bones that stand out from the toes are not only ugly aesthetics, but also cause a lot of difficulties when walking.Pending diseases lead to complications in the work of the whole musculoskeletal system.Therefore, everything cannot be allowed on the gear and contact the orthopedic if the first deformation sign appears