foot hallux valgus deformity of the first toe (hallux valgus) – orthopedic pathology that occurred at the level of the big toe joint with deviation of deformation of the metatarsal head medical plyusnefalangovogo into the bone, the thumb, outer side.
The problem is just an aesthetic wears air - hallux valgus angular first (big) begins as the pathology progresses the finger, slip the other toes, provoking, ductile deformation of their development.
Over time the pathological changes of the disease that causes all the structures of the foot (tendons, ligaments, bones and joints) leads to the development of:
- deformante metatarsophalangeal joint osteoarthritis;
- chronic bursitis (joint inflammation and mucous bag);
- exostoses (benign cartilaginous bone and the fetus) to the metatarsal heads;
- or cross combined platypodia;
- virusnogo (inside job), Then deviations of the metatarsal bone.
Definitely bone плюсневые Normal points parallel to each other. Bone is deformed under the influence of negative factors and is rejected plyusheva to the first direction (outward) as a result of the foot ligaments and tendons formed at small sizes tuber dysfunction occurs, loss of elasticity.
Depending on the severity of pathology features:
- A deviation in which the disease at an early stage, a large footprint, one side 15 degrees.
- In the middle stage, in which the first finger a deviation less than 20 degrees. In this case, the observed deformation, the second finger — shaped hammer and a thumb raised over remind.
- A heavy scene, in which the thumb of the deviation is 30 degrees. All the toes are deformed at the base of the first phalanx foot larger tuber sizes observed in these areas and place in existing high voltage formed of coarse corn.
The causes, development,
An important factor, a development that calls hallux valgus, the wrong shoes (a narrow foot, narrow models, tight shoes with narrow-toed or high-heeled shoes).
In addition, genetic factors and pathologies that affect the development of associated diseases.
Development of hallux valgus may be the result of:
- foot and lower leg injuries;
- inherently weak Nov-ligamentous apparatus (observed dysplasia of connective tissue, a systemic disease);
- polyneuropathy, rickets, cerebral palsy, secondary manifestation of an underlying disease);
- platypodia or low foot arch;
- arthritis with involvement of various joints of the combined group) the most common age;
- psoriaticheskij artropatii – inflammatory joint disease associated with psoriasis which is a chronic;
- gout - a metabolic disease accompanied by the accumulation of urate crystals in various body tissues;
- diabetes (diabetes is a disease of endocrinol hallux valgus deformity develops in the feet and legs poor blood circulation due to the increased load);
- increased joint mobility observed in Down syndrome and marfan syndrome;
- multiple sclerosis (a chronic autoimmune disease, myelin, nerve fibers accompanied by defeat shell);
- Toot disease Charcot - Marie- hereditary motor-sensory neuropathy with distal limb weakness and atrophy is seen in Nov a Nov;
- professional overvoltage leg (observed in ballet dancers, athletes, waiters, etc.);
- osteoporosis, chronic systemic diseases, skeletal, parity, significant bone loss;
- with the fast growth of the pubertate period (youth hallux valgus deformity, finger).
Hallux valgus is a foot shift increases the angle between the first metatarsal bones I and II, I-oh metatarsal bone. In this case, thumb toes, withheld a Nov left, begins to shift outward, the bones of the skull – form "to the bone" (bump, bump).
An overhang does not allow for the presence of a large finger, respectively, of normal ("watch"), and are rejected outside of your finger slowly.
Continuous live tuber, worn by shoe friction and pressure when the first metatarsophalangeal joint that causes inflammation of the mucus bag (bursitis).
Constant pressure causes a change. the bass bone in the field of I-oh metatarsal bones, swelling, tenderness, and sensitivity "bone" and the tissues around.
Changing the angle and position of the main thumb for early joint wear provoke a wrong, defeat a significant increase in cartilage and bone growth size. Increase the "bone" as a result, further development of the pathology and травматизации.
Symptoms depend on the stage of the disease.
In the first stage are observed:
- increase "bone" area in the metatarsophalangeal joint;
- pain proximal (second account of the nail tip) sections strengthened phalanx finger walking;
- Cover Skin redness and swelling in the field of "bone".
On average, a scene accompanied by:
- development, joint inflammation;
- pain and swelling;
- growth in the area of Education head metatarsal bones;
- average corn dry training under the phalange finger.
Running, is at a serious stage:
- sharp, abuse, pain, big at the base of the fingers and toes;
- well a significant visual growing "bone" (thorn accumulation);
- Flanagan and education under Nasser, the second and third skin abnormality.
Diagnostic hallux valgus foot contains:
- Learning history of the disease. During the interview, the doctor said uncomfortable symptoms which ill. A doctor is interested in what factors provoke pain (physical load, shoe wearing, walking) is available, and a history of trauma, systemic, metabolic and hereditary diseases, arthritis.
- External audit, which is in the process of watching the doctor, Hiking the patient (i.e. the degree of pathology associated with pain and gait disorders are determined) the position of the other fingers of the foot foot with the first rate education (experience, projection of a different joint sprain), bada, and other toes and of the region of the lesions (swelling and redness coloring shows the pressure). The doctor also controls the range of motion in the thumb, metatarsal joints, the presence of pain, and crepitations (65-75 degrees normal flexion and plantar flexion before - at least 15 degrees). Pain and crepitations existence is no sign of synovitis (inflammation of the joints the synovial membrane) and the stratum corneum thickening (keratosis) due to incorrect pressure indicative of the pathological'. Examined the thumb and of the movement for change (stretching before transfers during the transaction midline and frontal plane), and condition the skin and peripheral pulse.
- X-rays to determine subluxation and the degree of deformation joint and concomitant pathologies. Foot X-rays are performed 3-x appeared.
If necessary to exclude, prescribed for circulatory disorders ULTRASOUND of the veins to avoid associated diseases and preparation, laboratory studies and surgical treatment pre assign BT.
Treatment thumb-hallux valgus feet may be conservative and surgery.
Conservative treatment in an effective manner, only in the early stages of the disease. A suitable friction shoe load and will not cause a model that begins (in the initial stage, with the development of the models that carry the disease pathology, with a broad nose stops).
A doctor can recommend application:
- custom gaskets for Bursa (joint bag) thumb, low pressure paint;
- orthopedic products spacer, binding the finger prints and the changing load distribution;
- arch support, audio cassette, finger, foot, interdigital roll, blocking, more distortion.
The ability to reduce the sensation of pain severe deformation of orthopedic products, but these products it is not possible for the application getting rid of the pain completely.
Treatment inflammatory process includes:
- the application of non-steroidal anti-inflammatory drugs;
- corticosteroid injections;
- physical therapy (electrophoresis with calcium, ozokerit-paraffin applications, hydrocortisone phonophoresis);
- shock-wave therapy.
- massage stop, re-shaped, elastic restorative spasms and joint mobility;
- special exercises;
- walking and jogging barefoot.
Undergoing surgical treatment and conservative treatment of moderate to severe inefficiency in pathology (disease-carrying chronic, slowly progressive character, surgical techniques are recommended, and even mild hallux valgus).
Pathology various surgical techniques applied to resolve the purpose of:
- bursitis of the foot problem the first;
- reverse engineering of bone forming the thumb;
- Nov around joints in trim with To prevent recurrence.
The discontinuation of moderately pronounced deformation during the surgical intervention, just the accumulation on the joint bag. The outgrowth of that is removed in the process of the surgery with a small incision using special surgical planning in this area bursitis, bone leveling and then sutured the incision.
Maybe the thumb and metatarsal bones, zoning to be done.
Gotta zoning depends on the angle between the metatarsal bones, the first and second metatarsal bones (if it exceeds 13 degrees, refresh required).
It takes approximately 8 weeks for rehabilitation. During this period, it is recommended to put a special bandage for the injured leg or shoes with a wooden base (excluding the possibility of working in the field of re and permission травматизации tissues-normal). Directly after surgery, the patient may need crutches.
When bursitis of the appointment, after a period of physical therapy after surgery (approximately 6 procedures). Wearing shoes allows the front portion and extended use audiocassette, recover faster and have a normal walk.
Prevention of hallux valgus include:
- Foot improving blood circulation with the addition of herbal mixtures or sea salt.
- If you are wearing comfortable shoes in the correct position, the joint deformation observed walking rare) or orthopedic insoles application.
- Proper nutrition (some products use gout joints may be associated with overweight or defeat).
- Of support to help exercise footsteps.