Valgus Deformation of the first (thumb) Finger is an orthopedic pathology in which the finger is deformed, deviating.Mostly disease occurs in women after 30 years.In 3%, the deformation of Valgus is detected in people aged 15 to 30, in 9% in those of 31 to 60, and 16% in people over 60 years of age.The problem causes not only strong aesthetic discomforts, but also causes a change in all ligaments, tendons, joints and feet bones.
Pathogenesis
With Valgus deformation of the first finger, the angle between the first and other bones becomes more plus, the shift of the first metataric bone is moved.The thumb of the foot is transferred outwards, and the bones head out, forming a bone.This bone does not allow the thumb to match the norm, and gradually deviates outwards.Tubercle (bones) prevents you from wearing shoes, creates inflammation, friction and leads to inflammation of the bag of the first metatarsophalangeal joint.Gradually, the bones swollen and becomes lit, painful.The irregular position of the joint causes premature wear, crunchy lesion and increase the size of bone growth.This in turn causes foot trauma and further development of pathology.As the disease advances, the thumb shifts the remaining feet of feet, which leads to their bracket-shaped deformation.As the disease develops, leaders of plunplange joints, finger joints, chronic inflammation of the first metatarsophalangeal compound, flat fagot (chronic metatur bone head.
Shapes
In normal condition, metatarhous bones are parallel to each other.Under the influence of certain reasons, the first metatarsal bone deviates and therefore a small impact occurs in that foot, ligaments and tendons to lose their elasticity, their dysfunction develops their dysfunction.
The disease passes several phases:
- Early.At this stage, the feet of the foot of the foot is less than 15 degrees.
- Average.The deviation of the first fingers on the side is 15 to 20 degrees.At the same time, the deformation of another finger is observed.Get out above your thumb and becomes like a pattern with a hammer.
- Tough.Thumb devotion is 30 degrees.All fingers are already deformed, and at the foot of the first phalang there is a great growth of bones.In places where there is a large voltage of the feet, gross corn corn emerges.
Reasons
The main provocated factor from the appearance of the valgus deformation are irregular shoes.If a person wears tight shoes with a narrow toe or high, then his fingers are constantly in the wrong (compressed) position, which contributes to the development of the Valgus deformation.But not only it becomes the cause of the disease development.The following reasons affect the appearance of pathology:
- Traumatic damage to the lower leg and foot;
- Rickets;
- Cerebral paralysis;
- Polineuropathy;
- Low onions;
- Flat feet;
- Congenital weakness of muscle-ligamental apparatus;
- Chronic inflammation of joints caused by psoriasis;
- arthritis;
- Multiple sclerosis (accompanied by nerve fiber shell damage);
- Mellitus diabetes;
- gout (deposition of urita in body tissues);
- Hyper from common mobility observed during Marhan and lower syndrome;
- a youthful foot (a quick increase in the size of the rate in a teenage period);
- Charcot-Mari-Tuta disease (hereditary neuropathy, followed by atrophy of the muscles of distant limbs);
- Osteoporosis (bone loss);
- Stop the overcraft regarding professional activities (waiters, athletes, ballerina).
In the presence of provocating factors, the disease progresses quickly.
Symptoms
Symptoms of pathology depend on the degree of damage on the foot.In the first phase of redness, swelling of the tissue in the appearance of the bone, it is noticed in the finger phalan, intensifying during walking.In the average stage of disease development, pain, swelling, bone growth in the field of plus bones, dry corn under the middle finger finger appear.In a heavy stage in the soles of foot and thumb, heavy, exhausting pain appear.Dry corn formed, and keratinization of the skin appears under other and third fingers phalanes.
Diagnostics
Diagnostic measures start collecting the patient's history.The doctor asks him about disturbing symptoms, they are interested in what causes their appearance (leg load, stroked shoes), there are metabolic, systemic diseases in medical history, injuries of lower extremities, hereditary bones.Then an external inspection is done during which a person is requested to pass.The doctor is watching the patient's walk, while determining the intensity of pain.At the place of the thumb foot is studied, his location compared to the other fingers, explore the range of his flexion and expansion.Checking other external symptoms (swelling, redness, thickening of the layer of the layer under the bones of your fingers).FOUTENOGRAPHY OF THE FIOLE is performed in three projections to determine the degree of foot deformation, dyslocation of common and related pathologies.The ultrasound of the vessel is performed to exclude the disorders of the circulator in the legs.
Treatment
The therapy of the valgus deformation of the thumb foot is traditional and operational.In early stages, when you can do without surgery, doctors advise the selection of practical and correct shoes.It must not please the load on the foot, friction.Comfortable shoes slowing the progress of the disease.At the same time, the doctor will advise the purchase of special orthopedic devices:
- seals for a common thumb bag (eliminate shoe pressure);
- Intodassen 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 solve discomfort with the help.To remove pain and inflammation, not -steroidal anti -infalm ratio medications are used injective corticosteroids.To mitigate cramps and rebuild the mobility of common, massage and special gymnastics to relax the foot.
Efficiency of physiotherapy
The important role in the treatment of the deformation of Valgus is a game of physiotherapy.In order to eliminate the disease, doctors prescribe electrophoresis with calcium, phonophore of hydrocortisone, paraffin and ozoxic applications.One of the most efficient recirements of the deformation of Valgus Foot thumb is the therapy of the shock wave (UVT).This procedure implies a short-instepatic impact on the painful zone with acoustic low -Fread impulses.With the help of UVT, the symptoms of pain were eliminated, the effects on factors that contribute to their appearance were obtained.The procedure is performed using a separate device that generate shock waves.They affect only pathological areas, without influencing healthy tissues.With the help of ultrasound, metabolic processes are improved.UVT is not implemented in the presence of neurological, infectious, oncological, heart, somatic diseases, diabetes melitus, blood coagulation disorders.Hitting therapy is not prescribed for pregnant women, nourish women and children under 18 years of age.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 one UVT procedure.The doctor may prescribe at least 5-7 sessions.Depending on the stage of the disease, the procedure for conducting procedures is prescribed.Some are prescribed daily sessions, others will be sufficient for one process per week.The result of the treatment of UVT is maintained for a long time.
Surgical treatment
With the average and severe degree of deformation of Valgus, the thumb feet prescribed surgical treatment.Many methods have been developed to remove pathology to achieve the following goals:
- Eliminate Bursitis first finger feet;
- Worship of muscles located around the damaged compound to prevent relapse diseases;
- Perform the thumb bone reconstruction.
If the deformation is not strongly expressed, the growth of growth in a common bag through a small cut is removed.After surgery, a person needs rehabilitation, with a mandatory wearing of bend or shoe with a wooden solution, using a footprint, physiotherapy (at least 6 proceedings).Currently with the deformation of Valgus, the following operations are performed:
- A small correction of deformation.Small cuts are made on both sides of the thumb, through which, with the help of miniature mills, the position of metataric bones and finger phalan.
- Chevron-oosteotomy.The operation is performed by deviation of fingers from no more than 17 degrees.The growth was cut, and the thumb is fixed with a screw and titanium wire.After a while, the structure is removed.
- Scarf-oosteotomy.The operation is done if the angle of the thumbs of 18-40 degrees.During the intervention, using manual exposure, the position of metatarsal bones is corrected, and then fix it with two titanium screws.
A missed bone of the thumb foot is not only aesthetically ugly, but also causes many inconveniences when walking.The disease that has not completed the treatment leads to complications in the work of the entire musculos-bone system.Therefore, everything must not be allowed on equipment and contact orthopedic if first deformation signs occur