The deformation of the first finger (thumb) is an orthopedic pathology, in which the finger is deformed, diverting.Mainly the disease occurs in women after 30 years.In 3%, the deformation of the valgo is detected in people aged 15 to 30, in 9% in those who are 31 to 60 years and 16% in people over 60 years.The problem causes not only a strong aesthetic discomfort, but also causes a change in all ligaments, tendons, joints and foot bones.
Pathogenesis
With the deformation of the first finger, the angle between the first and second bone becomes more, the change of the first metatarsal bone is observed.The thumb changes out, and the head of the bones stands out, forming a bone.This bone does not allow the thumb to coincide with the norm, and gradually deviate out.The tuber (bone) prevents you from wearing shoes, creates inflammation, friction and leads to the inflammation of the bag of the first metatarsophalangeal joint.Little by little, the bone swells and inflames, painful.The inappropriate position of the joint causes its premature wear, cartilage injury and an increase in bone growth size.This, in turn, causes the trauma of the foot and the subsequent development of the pathology.As the disease progresses, the thumb changes the remaining fingers of the foot, which leads to its hammer -shaped deformation.As the disease develops, it leads to the osteoarthritis of the mostnoplange joints, the inflammation of the articular bags, the fingertips, the chronic inflammation of the bag of the first metatarsophalangeal joint, the displacement of the first metatarsal bones, flat pedes (chronic and transverse), metatarsal bones of the bones of the bones.Metal
Forms
Under normal conditions, metatarsal bones are parallel to each other.Under the influence of certain reasons, the first metatarsal bone deviates and, because of this, a small blow appears on the foot, ligaments and tendons lose their elasticity, their dysfunction develops.
The disease passes several stages:
- Early.At this stage, the trustee deviation of the foot is less than 15 degrees.
- Average.The deviation from the first finger to the side is 15 to 20 degrees.At the same time, the deformation of the second finger is observed.It rises above the thumb and becomes a shape for a hammer.
- Heavy.The thumb deviation is 30 degrees.All fingers of the foot have already been deformed, and at the base of the first phalanx there is great bone growth.In places where there is a large voltage of the foot, gross calluses appear.
Reasons
The main provocative factor in the appearance of the deformation of the valgo are irregular shoes.If a person wears tight shoes with a narrow foot or high foot, then the fingers are constantly in the wrong position (compressed), which contributes to the development of Valgus's deformation.But not only this becomes the cause of the development of the disease.The following reasons affect the appearance of pathology:
- Traumatic damage at the bottom of the leg and foot;
- rickets;
- Cerebral palsy;
- polyneuropathy;
- low foot of the foot;
- flat feet;
- Congenital weakness of the muscle-light apparatus;
- Chronic joint inflammation caused by psoriasis;
- arthritis;
- Multiple sclerosis (accompanied by damage to the shell of the nerve fibers);
- diabetes mellitus;
- gout (deposition of urrato in body tissues);
- Hyper of joint mobility observed during Marthans and Down syndrome;
- Youth foot (rapid increase in foot size in the adolescent period);
- Charcot-Mari-tuta disease (hereditary neuropathy, accompanied by atrophy of the muscles of the distal extremities);
- osteoporosis (bone loss);
- Strach stop in relation to professional activities (waiters, athletes, dancers).
In the presence of provocative factors, the disease progresses rapidly.
Symptoms
The symptoms of pathology depend on the degree of damage to the foot.In the first stage, redness, swelling of the tissues in the appearance of the bone, pain is observed in the phalanx of the fingers, which intensifies during the walk.In the average stage of disease development, pain, swelling, bone growth in the area of bone more, dry corn appears under the average finger phalanx.On the heavy stage in the sole of the foot and in the thumb, severe and exhausting pain appear.Dry calluses are formed, and the keratinization of the skin appears under the second and third phalanges of the fingers.
Diagnosis
Diagnostic measures begin with the collection of patient's anamnesis.The doctor asks about the disturbing symptoms, he is interested in what causes his appearance (leg load, walking, narrow shoes), there are metabolic and systemic diseases in the medical history, lesions of the lower extremities, hereditary bone diseases.Next, an external inspection is carried out, during which a person who passes is asked.The doctor observes the patient's march, while determining the intensity of pain.The position of the thumb of the foot, its location in relation to other fingers, explores the flexion and extension range is studied.The presence of other external symptoms (swelling, redness, thickening of the stratum layer under the bones of the fingers) is verified.Fotography of the foot is performed in three projections to identify the degree of foot deformation, the dislocation of the articulation and related pathologies.An ultrasound of the vessels is carried out to exclude circulatory disorders in the legs.
Treatment
The deformation therapy of the thumb of the foot is traditional and operational.In the early stages, when you can do without surgery, doctors advise choosing convenient and correct shoes.She should not please the load on the foot, friction.Comfortable shoes slow down the progression of the disease.At the same time, the doctor will recommend buying special orthopedic devices:
- Boards for the thumb joint bag (eliminate shoes 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 get rid of discomfort with their help.To eliminate pain and inflammation, non -steroidal anti -inflammatory drugs are used, corticosteroid injections are used.To relieve spasms and restore joint mobility, special massages and special gymnastics are prescribed to relax the feet.
The effectiveness of physiotherapy
Physiotherapy plays an important role in the treatment of valge deformation.To eliminate the disease, doctors recipe electrophoresis with calcium, hydrocortisone phonoforesis, paraffin and ozkeritic applications.One of the most effective the methods to eliminate deformationFrom the thumb of the foot are shock wave therapy (UVT).This procedure implies a short -term effect on the painful area with low frequency acoustic pulses.With the help of the UVT, the symptoms of pain are eliminated, the effects on the factors that contribute to its appearance are obtained.The procedure is carried out using a special device that generates shock waves.They only affect pathological areas, without affecting healthy tissues.With the help of ultrasound, metabolic processes improve.UVT is not carried out in the presence of neurological, infectious, oncological, cardiac, somatic, diabetes mellitus diseases, blood coagulation disorders.Shock wave therapy is not prescribed for pregnant women, infant women and children under 18 years.The procedure effect is observed after several procedures.The pain disappears, it becomes easier to walk.But it is impossible to completely remove the bone that stands out using a UVT procedure.The doctor can prescribe at least 5-7 sessions.Depending on the disease stage, the procedure for procedures is also prescribed.Some people are prescribed daily sessions, others will be enough for a procedure per week.The result of the UVT treatment is maintained for a long period.
Surgical treatment
With an average and severe degree of deformation of the thumb of the foot, surgical treatment is prescribed.To eliminate the pathology, many methods have been developed through which the following objectives are achieved:
- eliminate bursitis from the first finger;
- Lean the muscles located around the damaged joint to prevent the relapse of the disease;
- Make the reconstruction of thumb bones.
If the deformation is not expressed strongly, growth in the joint stock market is eliminated through a small incision.After the operation, a person needs rehabilitation, with the mandatory use of a bandage or shoes with a wooden sole, using foot correctors, physiotherapy (at least 6 procedures).Currently, with the deformation of the thumb, the following operations are carried out:
- Small deformation correction.Small cuts are made on both sides of the thumb, through which, with the help of miniature mills, the position of the metatarsal bones and the phalanx of the finger.
- Chevron-Oosteotomy.The operation is performed with a finger deviation of no more than 17 degrees.The growth is removed and the thumb phalanx is fixed with a screw and a titanium cable.After a while, the structure is eliminated.
- Scarf-oosteotomy.The operation is carried out if the thumb deviation angle is 18-40 degrees.During the intervention, using the manual exposure, the position of the metatarsal bones is corrected, and then fixed with two titanium screws.
The outstanding bone of the thumb of the foot is not only aesthetically ugly, but also causes many inconveniences when walking.The disease that has not finished treating leads to complications in the work of the entire musculoskeletal system.Therefore, not everything should be allowed in a gear and communicate with an orthopedic if the first signs of deformation appear