Hallux valgus is an unpleasant and fairly common problem. This pathology is characterized by the expansion of bone tissue around the joint at the base of the thumb. Most often, the curvature is formed due to prolonged stress, for example when walking with high heels, due to improperly selected or fairly narrow shoes, and also due to the anatomical features of the bones on the legs.
Description
Mostly hallux valgus is found in women. Although men and children are also prone to the onset of the disease. Often, at the very beginning, the bumps on the big toe are painless and do not cause much discomfort, except for a cosmetic defect. But over time, the problem will progress, pain, swelling and curvature will appear. Ultimately, the fingers can shift onto each other, the foot is deformed, and independent movement will become impossible. In this case, you will have to resort to surgery on the bone of the big toe.
A fairly large number of people call a bulging bone a cone. But there is no growth or formation in this case. A bump or bone is a protruding part of the head of the first metatarsal bone of the foot. It deviates from its normal position due to imbalance in the ligament complex of the foot. In addition to bulging, other symptoms are observed, such as:
- pain and swelling of the thumb joint, which is aggravated by pressure from wearing shoes;
- redness of the skin, rubbing, the formation of calluses due to improper position of the fingers;
- inflammation of the skin in places of constant mechanical stress;
- change in the general shape of the foot.
The curvature and deviation of the finger is of varying degrees. In some cases, deformation develops rather quickly, in others, the pathology progresses over many years. The stronger the severity of the disease, the more complicated the surgery.
Causes
The exact causes of the protruding thumb bone are unknown. But there are some factors that influence the occurrence of this pathology:
- Genetics. About 68% of cases of deformation are inherited.
- Poorly selected or uncomfortable, tight shoes. For example, a narrow toe or high heels.
- Congenital pathology. Bones on the legs may appear due to the features of the anatomical structure of the foot.
- Obesity. In obese people, being overweight exerts excessive pressure on the foot, causing deformation.
- Lifestyle. For example, sedentary work. Or, conversely, professional activities associated with a constant load on the legs. In particular, ballroom dancing or sports.
- Arthritis. Rheumatoid, psoriatic or gout.
- Other. These include joint weakness, excessive flexibility, low muscle tone, cerebral palsy and other abnormalities.
Treatment
There are several methods for correcting hallux valgus. At the initial stage, conservative methods of treatment are used. In cases of lack of positive dynamics, surgery is performed to remove the bone on the thumb.
Non-surgical treatment
Hallux valgus is characterized by deviation of the metatarsal bone and big toe. Various methods of non-surgical treatment are aimed at reducing pain and relieving discomfort caused by deformation. However, such manipulations will not lead to a complete cure. The condition will worsen over time. And ultimately, you still need surgery.
Non-surgical treatment methods are based on the use of the following means:
- painkillers and anti-inflammatory drugs;
- orthopedic insoles;
- specific shoes with extra width and depth;
- physiotherapy;
- special silicone cushions and tires.
Surgery
The only method to correct hallux valgus deformity of the foot is surgery to remove the bone on the big toe. During the procedure, the joint is corrected, and the curved finger returns to its normal position.
The goal of surgery is to reduce pain, align the foot and improve the quality of life. The operation on the bone of the big toe is usually not performed only for cosmetic reasons. They resort to it in cases where anti-inflammatory drugs, wearing orthopedic shoes and insoles, as well as other methods of treatment do not bring the desired result. The type of surgery performed depends on the severity of the deformity, the patient’s age, general health, activity level, condition of bones and connective tissue.
Laser surgery
In addition to surgery, you can correct the hallux valgus deformity with a laser. The undoubted advantage of this type of treatment is that there is no need to use gypsum and crutches. The patient will be able to move independently in special shoes the very next day after surgery.
Laser surgery is carried out in several stages. In case of small curvatures with the help of radiation, excessive bone tissue on the thumb is burned. In severe cases, after the above manipulation, the damaged joint is removed and the prosthesis is installed.
Laser surgery of the big toe bone has one significant drawback. This is a pretty high cost. Due to the fact that the procedure is carried out only in specialized medical centers, no quotas for laser treatment are provided. For comfort, modern equipment, the effectiveness of the operation and the speed of rehabilitation will have to pay a pretty impressive amount.
Indications
How to get rid of a bone on a leg using an operation? Surgical treatment is usually prescribed in cases where the deformation causes severe pain, and other methods of treatment do not help. It should be remembered that the operation is not cosmetic and is not intended to improve the appearance of the foot.
Indications for bone removal on the big toe are:
- pain in the thumb or in the entire foot;
- limitation of mobility;
- edema;
- redness;
- curvature and deviation towards the remaining fingers;
- change in the shape of the foot.
Preparation for surgery
Surgical intervention may be recommended when other treatments become ineffective, especially in severe cases. When deciding whether to perform surgery on the bone of the big toe, the specialist should evaluate the following factors:
- patient age;
- medical history and general health;
- level of activity and lifestyle;
- severity of symptoms.
In addition to collecting the above information, the patient is assigned an examination. It may include:
- X-ray of the feet to assess the severity of the deformity;
- Magnetic resonance imaging;
- general blood and urine tests;
- blood sugar;
- screening for HIV and hepatitis;
- electrocardiogram;
- fluorography;
- Ultrasound of the veins of the lower extremities.
Also, before the operation, it is necessary to consult an anesthetist, cardiologist, therapist and orthopedist.
Varieties of surgical treatment
There are many ways to remove the bone on the big toe. The choice of type of surgery depends on the degree of bone deformation and deviation of the fingers. Damage and condition of joints are also taken into account.
To correct and fix the deformed metatarsal ossicles in the correct position, the surgeon uses screws, wires and pins. Depending on the type of procedure, they may remain permanently or be removed later.
The operation on the bone of the big toe can be performed both under general anesthesia and with local anesthesia. Near the thumb, one or more incisions are made to remove damaged bone tissue and carry out further necessary manipulations.
After surgical treatment, it is necessary to wear a plaster cast to keep the metatarsal bones in the correct position until they grow together. It is also mandatory to use special orthopedic shoes.
The following is an overview of leg bone removal surgery.
Osteotomy
An osteotomy is the most common type of surgery for correcting hallux valgus deformities. During the procedure, the surgeon removes part of the bone tissue, and also forms bones inside the thumb. Using these manipulations, the joint of the toe is moved back to its natural position, which may include the removal of other parts of the tissue.
Distal soft tissue reconstruction
Distal soft tissue remodeling can be used to correct mild deformities. This type of surgical intervention aims to correct the pathology using procedures such as tendon release and capsule lift. Manipulations are necessary to create the correct location of the foot and thumb joint, as well as to achieve a cosmetic effect. Restructuring of the distal parts of the soft tissues can be carried out independently, although usually it is done simultaneously with osteotomy.
Arthrodesis
This type of surgery is performed in cases of severe deformation or destruction of the thumb joint. This may be a consequence of various forms of arthritis. With such a pathology, it is not possible to completely correct the curvature. The operation is aimed at creating complete immobility of the damaged joint. It is achieved by removing all the cartilage joints and connecting two or more bones together using grafts or metal pins.
Endoprosthetics
How is the operation to remove the bone on the finger? Endoprosthetics involves excising damaged bone at the base of the thumb. After this, a false joint is created by installing an endoprosthesis. Thus, with the help of an implant, the entire joint or only part of it can be replaced. As the bones heal, they connect to the scar tissue.
Rehabilitation
Each patient is individual. Different people recover differently. For some, this period will take six weeks, while others will fully return to normal only after a few months. But in general, rehabilitation after bone removal on the thumb usually takes three to four months.
After surgery, the leg and ankle will become swollen for a long time. To reduce swelling, it is necessary to keep the limb in an elevated position. You can also apply an ice pack. During this period, the patient will not be able to wear normal shoes and walk as usual. Crutches may be needed to move. It is necessary to step on the heel when walking. Before returning to the usual way of life, the patient must walk in a special bandage that fixes the leg and bones in the correct position. This is necessary to protect bone prostheses from damage, and joints and bones from displacement. Also during rehabilitation and after it is recommended to wear special orthopedic shoes for the prevention of recurrence of hallux valgus deformity of the foot.
If pain occurs, the patient can take painkillers prescribed by the attending physician. It should be noted that aspirin or some pain medication may increase the risk of bleeding. The doctor may also prescribe antibiotics to prevent infection after surgery.
After surgery, it is important to keep the injured limb clean and dry. Before the stitches are removed, wet feet should be avoided. When taking water procedures, you should wear a plastic bag or wrap your foot in film.
During the rehabilitation period, the patient may be prescribed physiotherapy and special therapeutic exercises. These procedures will help restore the strength and range of motion of the foot after surgery.
The patient must comply with the prescribed regimen. If the following symptoms appear, you should urgently contact a medical institution:
- temperature increase above 38 degrees;
- redness, severe swelling, bleeding at the incision site;
- severe pain around the incision;
- swelling in the lower leg of the affected foot.
Complications after surgery
Surgical treatment is always associated with various risks. After surgery on the bone of the big toe, the following deviations may occur:
- infection;
- deep vein thrombosis (bleeding disorder);
- stiffness in the joints of the toes;
- prolonged fusion and healing, as well as fusion in the wrong position;
- painful sensations;
- damage to nerve endings;
- large swelling;
- the need for further surgical treatment;
- the formation of scar tissue and keloids;
- repeated relapse (appearance of bone, deformation of the finger or the entire foot);
- complex regional pain syndrome - a condition that causes prolonged (chronic) burning pain in one of the limbs.
If the above symptoms and complications occur after surgery, you must consult a surgeon. A specialist can give advice on how to deal with this, including further treatment options.
Pricing
The cost of surgery on the bone of the big toe varies depending on the type of surgical intervention required. To make an arthrodesis of one joint costs about fifty thousand rubles. With severe damage, the price increases.
The cost of an osteotomy of the metatarsal bone starts at forty-seven thousand rubles. Distal soft tissue reconstruction - from forty-nine thousand rubles. Pricing directly depends on the complexity of the necessary manipulations and the severity of the patient's condition.
Endoprosthetics of the joints of the foot is the most expensive operation. Its cost is about ninety thousand rubles. The price of the prosthesis is also about ninety thousand rubles.
Basically, the prices for bone surgery on the big toe are quite high. But all of the above surgical procedures can be performed free of charge under the compulsory medical insurance policy if there is a quota. To do this, you need to visit a traumatologist, get the necessary directions and undergo an examination.
Reviews
Large toe cone surgery is a common surgical procedure, especially among women. Wearing high heels and heredity are provoking factors. Positive feedback on the operation of the bone on the big toe. Basically, all patients are happy with getting rid of this problem. Due to the deformation of the finger, women are forced to wear wide and ugly shoes, which are rather difficult to pick up. After the operation, not only discomfort passes, but also a cosmetic effect is achieved. Depending on the method of removing the bone on the leg, recovery takes place in different ways. Reviews after a laser operation of the bump on the toe of the thumb are also good. Many say that rehabilitation after such treatment is a little faster. In general, patients return to a normal lifestyle, begin to wear high-heeled shoes after three to four months.
Prevention
Compliance with certain rules will help reduce the risk of bone deformation on the big toe. First of all, this is the correct selection of shoes. If your relatives have hallux valgus, it is necessary to take care of preventive measures in advance. Poor-fitting shoes, high heels, a narrow cape contribute to the protrusion of the metatarsal bones and the curvature of the fingers. Shoes or boots should be wide so that the fingers are not pressed together. There should also be enough space for their movement. When choosing shoes, you need to choose the right size.