Halus valgus is a deformation of the fingers, in which small growths form on the inside of the foot, causing discomfort, and in some cases simply unbearable pain in the joints. This is an age-related disease. It progresses gradually over several years, and therefore mainly elderly people suffer from it.
It is worth noting that the curvature of the foot is much more likely to develop in women than in men. It is believed that this is due to wearing shoes with heels.
Causes of occurrence
There are several reasons why halus valgus is formed. According to recent studies, genetic predisposition is important. Among other reasons, it is necessary to highlight such as:
- longitudinal-transverse flat feet;
- uncomfortable and low-quality shoes;
- overload;
- congenital curvature of the foot.
Except in special cases, the disease begins to manifest itself most actively in people over 50 years old. In the presence of defects, the leg joint located near the big toe begins to constantly shift to the sides, forming a bump on the leg.
This happens as a result of the fact that the articular membrane with fluid is injured when displaced. This causes a fairly strong friction between the joints, resulting in bone growths. As a result, severe pain occurs when wearing shoes. Failure to pay attention to a problem in a timely manner can lead to disability. That is why when a halyus valgus occurs, the operation is the most effective method of getting rid of the problem.
Indications for the operation
The main essence of such a growth is the gradual progression of joint deformation, which provokes the deviation of the finger. Due to the presence of defects and the likelihood of complications, it is often recommended that an operation be performed with halus valgus, rehabilitation after which lasts up to 6 months.
The indication for surgical intervention is the advanced stage of the disease, when other methods do not bring the desired result.
Types of Intervention
There are several types of surgery for halus valgus. Photos of the results indicate that all types of intervention are quite effective. Such treatment may be:
- minimally invasive;
- reconstruction;
- arthrodesis.
Minimally invasive intervention is characterized by the fact that the operation is performed through a small puncture after the use of special fixatives, which are effective with slight deformation.
The reconstruction operation is used in severe stages of deformation. To fix the required position, special devices are used. Arthrodesis is indicated for significant lesions and severe deformation, which interferes with joint mobility. This makes it possible to effectively eliminate deformation and pain when walking.
During the operation with halus valgus, the surgeon restores the normal position of the joints, and also eliminates the existing deformation. Another type of intervention is scarf. During the operation, the deformed area is removed from the bone tissue, and then the edges are matched.
Diagnosis before surgery
Before you go to surgery for halus valgus, you need to undergo a full examination. Clarification of the diagnosis requires a specialist to fully study the medical history and conduct an examination. In addition, additional research methods are used. An X-ray examination is required, which involves the creation of images in several projections. This helps to determine the magnitude of the deformation angle and indicates how the position of the foot has changed.
In addition, computer research is required, including plantography and podometry. This allows you to identify even the earliest changes and prevent the subsequent progression of the pathology.
Sparing intervention
A sparing operation for halius valgus in Moscow and other cities is performed in the orthopedic department of many clinics, as this is a less traumatic intervention. Surgical treatment is divided into several types, which are combined in several directions, namely:
- impact on bone structures;
- on soft tissue;
- complex interventions on the feet.
Minimally invasive surgery for hallux valgus is shown at the initial stage of the development of pathology. In this case, the effect is on muscle tissue and tendons. As a result of the intervention, the existing discomfort while walking, as well as an extra defect, is effectively removed.
Minimally invasive surgery is performed in stages. Initially, small punctures are made, into which micro-tools are then inserted and the joint bag is opened. Then the bones are filed with microfreza, which allows you to get rid of curvature. All ongoing manipulations are tracked on the monitor.
Surgical reconstruction
Reconstructive operations to eliminate valgus deformities of the foot are prescribed mainly for medium and light defects. Initially, a small longitudinal incision is made in the lateral plane of the foot (2-4 cm). Then the growth is removed, the joint is installed in the correct position. Then the ligaments are restored.
Bone fragments are fixed with compression screws made of titanium. These designs generally do not cause any discomfort, so they are not subsequently taken out. If after surgery with halus valgus with screws there is a certain discomfort, then they are removed after three months.
Radical intervention
With this method, the deformation is eliminated using fixed joints. However, this does not affect the physical activity and gait of a person. The operation helps to quickly eliminate the existing defect, as well as effectively and quickly get rid of intense pain.
They resort to arthrodesis if other methods have not brought the desired result. Initially, a small open incision is made, the surface areas of deformation are excised, and then the fragments of the joints are firmly connected with screws. This helps to restore the natural structure of the joint, which allows you to completely eliminate the existing symptoms. Screws after the recovery process are not removed.
Rehabilitation period
It is imperative to carry out comprehensive rehabilitation after surgery for Halyus valgus, as this will allow recovery much faster. Recovery is fairly quick, but you need to follow certain precautions.
It is absolutely necessary to ensure complete rest for the legs, since the lack of load will help to eliminate postoperative edema much faster. Be sure to use the means recommended by the doctor for faster healing of the dissection area.
During the first 3 weeks after surgery, it is not recommended to step on the foot completely and it is permissible to wear only orthopedic shoes. Do not have surgery on both legs at once.
Reviews about surgery for Halyus valgus and rehabilitation are mostly good, but it is worth remembering that a full recovery can take several months. All this time you need to be very careful about your legs and correctly distribute the load.
Postoperative Recovery
The rehabilitation program after surgery for halus valgus is compiled separately for each patient. In this case, one must take into account the patient’s well-being, type of intervention, the risk of complications, as well as the presence of concomitant diseases.
On the first day, it is advisable to begin to develop the operated area, namely, little by little to move the toes of the feet. It is allowed to walk around the third day, using special orthopedic orthoses. This will allow you to slightly relieve the operated area.
Staying in a hospital generally does not exceed 10-14 days, but after surgery with a halus valgus with screws, rehabilitation takes a longer time. The subsequent rehabilitation program is carried out at home under the strict supervision of an orthopedist. It is imperative to perform a set of physiotherapeutic procedures selected by the doctor, due to which healing will occur much faster. The complex of physiotherapy includes such as:
- shock wave therapy;
- electrophoresis;
- massage;
- Exercise therapy.
It is not worth neglecting such procedures, since without the required rehabilitation, an operation with halus valgus can give only a short-term effect. If you do not follow all the doctor's recommendations, then a relapse may occur.
Approximately 2 months after the operation, the patient can start exercising on an exercise bike or visit the pool, however, it is not recommended to heavily load the foot. In order for recovery to be more effective, it is recommended that you periodically keep your feet above head level, as well as do massage. At night, it is advisable to use a corrective tire.
Basically, a full recovery period takes at least 6 months. Throughout this period, it is important to use orthopedic devices to fix the joints. If there is a need for intervention on both legs, it is recommended to do this with an interval of 3-6 months.
Physiotherapy
It is recommended to carry out special exercises for rehabilitation, which will help to forget about the pathology forever. For complete postoperative recovery, as well as the return of mobility to the operated finger and healing of injured tissues of the leg, it is recommended to perform gymnastics in three approaches, in strict sequence.
In addition to the complex of therapeutic exercises, it is very useful to resort to special massage procedures. In addition, you can use not only medical professional massage. Any warm-up of the toes at home will have a good effect on the return of the natural mobility of the joints. In addition, it is recommended to wear only orthopedic shoes during the recovery period.
Medications
In the case of severe pain during the recovery period after surgery, it is allowed to take anti-inflammatory drugs. Painful manifestations arise due to the increased activity of the patient, as well as loads on the leg.
The foot can also swell very much, which is accompanied by severe pain. Tissues near the wound surface can be lubricated with ointment or gel, which have analgesic and decongestant effects.
Orthopedic shoes
After the operation, you need to wear orthopedic shoes. The front must be flexible and movable. She should not squeeze metatarsal bones or fingers. In addition, shoes should not have a very high heel.
It is important to choose shoes made exclusively from natural materials, as they enable the foot to breathe, eliminate rubbing and excessive sweating. Be sure to have an anatomical arch support to evenly distribute the load on the foot. This will avoid relapse, as well as pain and discomfort.
Contraindications for surgery
The operation can be performed far from always, and even if there are absolute indications, there are a number of patient conditions in which it is impossible to carry out such manipulations. Contraindications include:
- diabetes;
- high blood pressure;
- insufficiency of the functions of internal organs;
- purulent infections;
- pathology of the hematopoietic system;
- blood clots in the veins;
- bleeding disorder;
- chronic bone diseases.
It is very important to pre-diagnose in order to determine the presence of contraindications. This will avoid the development of complications.
Possible complications
It is important to carry out diagnostics before the intervention, as they can develop complications after surgery with halyus valgus. Therefore, the identification of concomitant diseases will help reduce postoperative risks. Among the possible violations, the following should be highlighted:
- blood clots may form inside the vessels;
- bone undergoes necrotic destruction;
- wound infection is possible;
- damage to nerve endings occurs;
- swelling of the tissues occurs;
- the range of motion is disturbed;
- numbness of the feet may be present.
Given all the possible complications, the operation is carried out only after a comprehensive diagnosis.
Patient Reviews
According to reviews, surgery for halus valgus with minimally invasive intervention does not require too long recovery. However, it is worth noting that in the future the joint may deform again, so you need to wear comfortable shoes, use orthopedic insoles that help reduce the load on the foot.
Testimonials after surgery for halyus valgus with the use of screws allow us to judge that such a reconstruction is highly effective with little damage. However, if the pathology was detected at a late stage, minimally invasive and reconstructive techniques are useless.
After the operation with halyus valgus, the reviews are quite good, as they say that the screws inserted into the bones do not manifest themselves in any way and the result is assessed as positive. They indicate that the operation is quite effective and quickly helps to cope with the existing pathology.
Reviews regarding the operation are good enough, especially if you conduct it at the initial stages of identifying the pathology. They say that after removing the cone, you must strictly follow all the recommendations of the doctor, as well as eliminate excessive load on the feet. If everything was done correctly, then the deformation will no longer bother.