Bunions (Hallux Valgus) treatment
A bunion or hallux abducto valgus is a deformity of the joint affecting the big toe joint of the foot. The medical term hallus abducto valgus (Lat.) literally means the big toe (hallus) abducted (abducto) outwards (valgus). The cause of this deformation is in increased pressure on the transverse axis of the foot. This pressure occurs, if you stand on your toes or wearing high-heeled shoes.
Another factor, causing deformation, is the pressure on the joint area from the side and top (this action is caused by narrow-fitting shoes). First, the increased pressure on the foot and the friction of shoes causes inflammation of the joint capsule, located around the joint. The constant irritation and inflammation lead to the development of osteoarthritis and the formation of bone production. A bunion is gradually, covered with a thick, calloused skin. In addition to the external cosmetic defect, the such change in the shape of the big toe joint can cause pain when walking, decreasing only in loose, soft shoes, or when walking barefoot.
Causes of Bunions
The most common cause of this deformity is wearing tight and narrow high-heeled shoes. It is noted, that in such cultures, where people walk barefoot, the disease does not occur;
Professional activities: ballerinas and dancers have disproportionately higher pressure on the foot when walking;
Age: the majority of ill people is older than 50 years;
Various diseases affecting other joints.
Conservative and surgical methods are used for treatment bunions. Sometimes, both options are combined. The choice of treatment depends on many components: the degree of deformation of the joint, the age and general condition of the person, and etc. In any case, orthopedist will start with a conservative therapy, in case of its inefficiency, surgery will be recommended.
Conservative Methods of Treatment
First of all, a patient will be offered to choose comfortable shoes in order that arthritis and deformity do not progress further. Choose orthopedic insoles and arch supports to compensate for the flat feet, if any. Wear special paddings that allow fixing the big toe and redistributing the pressure on the foot. Such measures help in the early stages of osteoarthritis. As the drug therapy, non-steroidal anti-inflammatory agents, hormones, and physical therapy are prescribed. If conservative treatment is ineffective or inefficient, the surgical correction is recommended.
Bunion surgery is carried out in different clinics and centers; moreover, it is included in the list of free medical services, guaranteed by policy MLA. The difference of a place for treatment is in the choice of the method of operation. Doctors of our clinic have mastered the most advanced of them.
The Chevron Method
The world has developed more than one hundreds of different types of surgery for correction of hallux abducto valgus. In our clinic we use Chevron technique surgery with using original developments. This method has received the name in honor of the stripe of V shape on military clothing. Sometimes it is called the Austin operation, after an American surgeon, who was the first to perform such a correction in 1961. The great advantage of this method is that it is not necessary to use steel axis pins, and therefore, there is no need for re-intervention for their removal. The scar on the foot remains minimal, almost insignificant. Surgery can be performed under local anesthesia or with the introduction to short-term intravenous anesthesia. The entire procedure takes less than half an hour and one will be able to stand on the operated foot in the first hours after the operation.
According to patient’s good health condition and willingness, doctors can remove the bones on both feet simultaneously. If the operations are done with a break, then the optimal interval between them should be not less than two months. Body must be given time to rest after surgery.
The Operation Run
During the operation a surgeon cuts the end of the metatarsal bone (long bone, which goes to the big toe) and, gently moving it, corrects the deviation. Surgery revision of soft tissues is made simultaneously.
Contraindications to surgery using the Chevron method
– High degree of hallux valgus;
– Decompensating of concomitant disease;
– Changes in blood coagulation;
– Arthritis under deformation.
During first few days after surgery, the pressure on the operated foot should be dosed. It is not allowed to walk more than 5 minutes a day, the foot should be put right. A doctor will show how to put a foot correctly, the duration of pressure should be gradually increased to 5 minutes a day. Approximately on the eleventh day after the intervention, you are ready to start work. Recovery speed depends on the characteristics of the organism, but there are general requirements and recommendations.
Immediately after the removal of bones on your feet, you will need loose shoes. Because there will be a bandage and a small edema of tissue at the surgical site on the leg. The best option will be sports sandals, whose width is adjusted.
During two weeks after the surgery it is necessary to do simple exercises of complex physiotherapy. It will help to knit the metatarsus bone back together and keep joint mobility. In a month, it is necessary to make the control X-ray, on which an orthopedist evaluates the effectiveness of the held correction.
Any operation may be accompanied by the development of complications. Intervention within using the method Chevron is no exception. No one can predict the individual response of the organism to agents for anesthesia and the surgeon’s manipulation. The development of the following complications is theoretically possible:
Nerves or blood vessels damage during the operation;
Abnormal bones union;
Disorders of circulatory system of metatarsal bone at the surgical site.
It is possible to prevent the development of complications following doctors’ recommendations and passing a detailed examination before the surgical intervention.
Recommendations for a Long Period Recovery
Foot bump may relapse, if triggers are not removed. It is obligatory to change shoes. In a year after the removal of the foot bone, it is forbidden to jog and jump. At this time, it is necessary to protect the foot against impacts (for example, in the game of football). The heel of shoes should be no more than three centimeters. These restrictions are connected to the fact that this period goes to the full recovery of the operated joint. As time goes by, all restrictions will be removed and life will return to normal.
Doctors always SAY that one of the reasons causing a deformation of the big toe is called IRREGULAR shoes. What shoes are right from the point of view of orthopedist? The optimal pressure distribution on foot occurs when the heel height is no more than 5 centimeters. The toe of shoes should be slightly rounded. This does not mean that doctors have declared war to the “spike heels”, and are dreaming of changing the whole world to slippers of “goodbye youth” style. One can and should wear high-heeled shoes. However, this footwear is not foe every day. Constant wearing of high-heeled shoes or narrow, but very fashionable, will cause bunion back and lead to the operating table again.
Other Methods of Surgical Treatment
In addition to widespread operations with using the Chevron method, it is performed feet bone removal by mini invasive surgery in our clinic.
Endoscopic Removal of Feet Bunions
Almost everyone is somehow familiar with endoscopic surgery. But few know that there are special instruments for endoscopic surgery on the joints. They are called an arthroscope and micro scalpel. Feet bunion is removed through the skin puncture with their help under visual control. Micro scalpel and special mini drills allow the surgeon to gently remove the excesses of bony tissue to check the joint cavity and surrounding soft tissues. It is not necessary to set bones after such operation.
Modern methods of removing the feet bunions help regain lost health and help get rid of cosmetic defect. However, all the doctors’ efforts will not succeed if you do not follow orthopedists’ recommendations. This concerns not only the behavior after the conducted surgical intervention. Careful attention to your own health is necessary. Visit to doctors in the early stages of the hallus abducto valgus allows doctors to perform a correction by little traumatic way. To prevent further joint damage. To prevent signs of arthritis. Any disease is easier to treat in the early stages. Do not approach most operations thoughtlessly. Even if surgical intervention is minimal, surgery is meant to remain surgery. And success depends not only on the professionalism of a team of doctors, but also on how serious a patient is set to recover.
Please contact us for further information