Taylor or “tailor's foot” deformity is abnormalities in the fifth metatarsal bone. Due to this pathology, a lump appears in the area of the base of the little toe of the foot. This type of pathology is no less common than changes in the thumb, but the symptoms are much more severe.
The name of the disease was given several centuries ago. This was due to the fact that deformation most often appeared in tailors who sat with crossed legs throughout the working day. As a result of this, they rested with the outer edges of the feet on the floor, and they had “bumps” near the little finger, which brought a lot of inconvenience.
Possible causes of the development of pathology
Taylor deformation very often occurs against the background of a genetic predisposition. However, a change in the architecture of the leg bones can occur due to the presence of flat feet or microtrauma. A possible cause may be improper load on the legs, wearing tight shoes.
In medical practice, there are three main reasons:
Title | Features |
Post-traumatic | It is characteristic for abnormally fused foot bones. In this case, there is only one way out - corrective osteotomy, that is, a fracture of incorrectly fused bones. |
Structural or congenital | It occurs against the background of weak tendons, in such cases, the ligamentous apparatus is simply unable to hold the bones in the correct position. In such situations, wearing narrow shoes, which leads to severe deformations, is very dangerous. |
Functional | Most often occurs against the background of instability of the 5th ray of the foot. It can also be an uncompensated varus form of the foot or a congenital defect of the metatarsal bones, and tendon weakness. |
Symptomatology
Taylor deformity is characterized by redness in the fifth toe. Swelling may appear and a lump may form, constant pain torments.
The intensification of symptoms is characteristic during and after wearing tight shoes, up to the development of the inflammatory process. Although some patients note that it is difficult for them to move around even in loose shoes.
For many patients, such deformations, first of all, are a cosmetic defect, moreover, with this disease it is quite difficult to choose shoes.
Diagnostics
As a rule, there are no difficulties in the diagnosis process in the presence of Taylor deformation. After all, changes in bone tissue are visible to the naked eye. On palpation, a specialist can detect a thickening of the head of the metatarsal bone or problems in the capsule area near the joint.
X-ray examination
In any case, even if after the examination it was possible to find problems in the fifth toe, the patient is referred for an X-ray examination. This type of examination allows you to determine the need for Taylor deformity surgery and the degree of bone damage, in particular:
- to what extent deviations in the lateral angles;
- the presence or absence of fractures, by the way, which the patient might not even know about;
- whether the head of the metatarsal bone is enlarged;
- the angle between the 4th and 5th fingers;
- are there arthrosis of the joints.
Assessment criteria
The fundamental criterion for assessing the condition of the patient is an indicator of the angle between the fingers. Ideally, the distance between the 2nd and 5th ray should be 14-18 degrees, and between the 4th and 5th - 7-9 degrees. If there are deviations from the norm, then we can talk about the presence of the disease.
The second evaluation criterion is the shape of the metatarsal head. Normally, the deviations should not exceed 2-3 degrees, in the presence of pathology, the angle can reach 8-9 degrees.
Therapeutic measures
Treatment of Taylor deformity in not very advanced cases begins with non-surgical techniques. First of all, the pain stops and the inflammatory process is removed. In the future, the doctor helps the patient to choose the right shoes, which should have a wide toe. Orthopedic inserts in shoes may also be recommended to reduce friction around the fifth finger.
Non-steroidal anti-inflammatory drugs may be recommended to reduce pain. Also, the pain can be relieved with the help of a cold, wrapping a leg with a towel with ice packs in the evening. This procedure cannot be longer than 20 minutes. In some cases, blockade can be carried out, that is, painkillers injections are introduced into the periarticular region. In such cases, corticosteroids are used.
Surgical intervention
According to reviews, the Taylor deformation operation allows you to get rid of the problem once and for all. The essence of surgery is that the exostosis that forms on the head of the fifth metatarsal bone is removed. After removal, the bone itself is sawn and displaced to the place where it should be. Fragments are fixed with a screw.
After such an operation, there is no long rehabilitation, as a rule, the patient rises to his feet on the second day. At the same time, he does not need immobilization or additional supporting structures to move.
In the first months after surgery, special shoes will be required to remove the load from the forefoot. Full walking is already possible on the 4th-6th week after surgery.
Modern techniques
Today, in the treatment of Taylor's varus deformity, there are a number of possible surgical operations, the choice of which depends on the degree of curvature, physical activity of the patient and age.
In addition to exostozectomy, that is, removal of the growth, distal osteotomy can be performed. Such an operation is indicated in the presence of type I and type II curvature.
In the presence of type II or type III curvature, an osteotomy is performed. And proximal osteotomy is performed with a curvature of type IV and V.
Prevention
Despite the fact that in most cases, deformation occurs against the background of a genetic predisposition, nevertheless, the disease can occur under the influence of certain factors. The correct selection of shoes is of great importance. Looking at photos with Taylor's deformation, it becomes clear that narrow shoes are not suitable for such people, and wearing heels is not recommended. You can wear a low platform. Shoes should not crush the vessels and joints on the legs, allow the load to be distributed correctly throughout the foot.
If there is a suspicion that deformation may occur, then you can do gymnastics for the feet, but only on a regular basis. A family doctor or orthopedist will tell about such exercises. As a preventative measure, you can use barefoot walking on uneven surfaces.
And most importantly, if you suddenly notice redness or a bump in the area of the little finger of the foot, be sure to consult a doctor to prevent the development of deformity and not to decide whether or not to decide on a surgical operation.