Bone on the big toe
- Causes of bone on the big toe
- Symptoms "bones on the leg"
- Therapeutic treatment of bone deformities on the leg
- Surgical treatment of bone deformities on the leg
- Possible consequences of "bone" on the big toe
- Prevention of "seed"
The deformity of the foot, which has received the popular name "bone on the leg," is the deviation of the thumb from its normal physiological position. Of the 100 patients who detect this disorder, approximately 85 are women and only 15 are men. In medicine, the bone is called valgus or Hallux Valgus.
Causes of bone on the big toe
Changes in the structure of the foot may precede the appearance of a bone on the foot, which remain almost unnoticed until a noticeable cosmetic defect develops. Among the causes of valgus deviation, orthopedists call:
- Transverse flatfoot;
- Curvature of the hind foot;
- The divergence of the first and second metatarsal bones, increasing the angle between them;
- Contracture or shortening of the Achilles tendon;
- Enhanced sports and dancing with a large power load on the foot;
- Shakiness of I metatarsophalangeal joint;
- Paralysis of small muscles of the foot;
Work of foot when walking is broken. The main points of support are shifted, the load is redistributed, and subluxation occurs in the area of the I metatarsophalangeal joint. The head of the metatarsal bone is shifted to the side, sticks out under the skin, and bone and cartilage growth begins to develop around it. This is how the "bone" is formed.
The thumb also starts to bend due to subluxation - it deviates in the opposite direction and is superimposed on the other toes. Without timely treatment, the foot can acquire a frightening, altered form, which is very difficult to correct.
Particularly contributes to the development of valgus deviation love women to narrow tight shoes with high heels. When walking in such shoes, body weight is transferred to the forefoot, which leads to deformation of the metatarsal joints. Athletes and ballet dancers also have an increased risk of bone development due to the load on their feet. One of the risk factors for the development of the “bone” can be leg injuries that were transferred in the past, disrupting the normal position and work of the feet.
Symptoms "bones on the leg"
The first symptom is the deviation of the big toe inside. This is the way to distinguish the valgus deformity from gout and other joint diseases. The longer the disorder remains without treatment, the more the thumb rejects; then it is superimposed on II and III toe.
Next comes the bump - the bulging of the metatarsal bone under the skin. Around the head of this bone begin to deposit calcium salts, further increasing the bulge and causing discomfort. Then the pain symptom joins - the bone hurts from rubbing with shoes, and later in a state of rest. Due to the shakiness and deformity of the I metatarsophalangeal joint, inflammation develops, the surrounding tissues swell, which further intensifies the pain. Reddening of the skin in the area of the joint may turn into local purulent inflammation.
The affected foot becomes flatter, the patient's gait is disturbed, the foot begins to mow on the inner side when walking. Visually, the legs appear to be crooked, and the foot - twisted. Having barely noticed an altered joint on the leg, one should consult a specialist for consultation and treatment.
The diagnosis of “valgus deformity” can be made on the basis of a visual examination and anamnesis, but for clarification, radiography of the foot is prescribed in frontal and lateral projections. The picture shows the subluxation of the I metatarsophalangeal joint, the angle of the valgus deviation of the finger and the metatarsal is determined. In parallel, a differential diagnosis with gouty joints, arthritis and arthrosis; concomitant diseases are determined, if any.
There are 4 stages of development of the “bone” on the big toe:
- Stage 1 - the angle of deviation of the thumb from the normal position does not exceed 20 °;
- Stage 2 - the angle of displacement from 20 to 30 °;
- Stage 3 - from 30 to 50 °;
- Stage 4 - more than 50 °.
Therapeutic treatment of bone deformities on the leg
The diagnosis and treatment of valgus foot deformities is carried out by an orthopedic surgeon. At an early stage, when the first signs of bias appear, conservative treatment methods are possible. The simplest therapeutic measures include:
- wearing orthopedic insoles that help eliminate flat feet;
- the correct mode of work and rest;
- if the occupation of the patient is associated with loads on the legs, it is recommended to take a break or change the type of activity;
- women are forbidden to wear shoes with heels (heels should not be higher than 7 cm) and shoes that squeeze the foot.
Perhaps the appointment of special discharge bandages and silicone interdigital inserts. These devices return the thumb in its physiological position, and with prolonged wear can slow down further deformation of the feet.
Wearing orthopedic insoles can be very effective. Insoles are made with the order, individually for each patient. With the “bone” on the foot, the insole is formed using an instep support that supports the transverse arch of the foot. Due to this, the load on the foot is distributed correctly; the foot is not mown on the side when walking.
In modern medicine, several technologies have been developed that increase the effectiveness of treatment of the “bone”. They do not eliminate the curvature, but can serve as a preparatory stage or an auxiliary measure for more thorough treatment.
Shock wave therapy is a hardware method for treating valgus deviation, flatfoot, heel spurs. With the help of acoustic shock waves in the tissues, blood flow is activated, nutrition is improved, the damaged cells are restored and renewed.
As a result, calcium deposits are destroyed in the "bone" - the resulting growth becomes much less after 5-6 weeks of therapy. Elasticity of muscles and ligaments of the foot increases, pain and swelling go away, inflammation in the area of the deformed joint is reduced.
Therapeutic massage for valgus deviation relieves the excessive tension of small muscles of the foot. During the course of the massage, the joint tries to regain its physiological position, increase its mobility, eliminate overload and discomfort. In severe inflammation of the I metatarsophalangeal joint massage is contraindicated!
Corrective orthopedic tire is designed for a long period of wearing - the first effect of its use is noticeable after 1-2 months. The valgus splint pulls down the big toe, returning it to the correct position. Additionally, it corrects the transverse arch of the foot, lifting it. The tire is worn constantly, it can not be removed during sleep. The mobility of the foot is maintained.
Laser therapy for the “bone” on the leg is the warming up of the inflamed area with a laser. Due to the thermal effect, calcium deposits are destroyed, swelling is reduced, pain is removed. Tense muscles of the foot relax, spasms are removed.
Ultrasound therapy has the same thermal effect, which relaxes the small muscles of the foot and triggers active blood flow in the vessels and capillaries, helping to restore cells and tissues. In addition, ultrasound contributes to the production of collagen in the tissues, therefore, increases the elasticity of the foot, strengthens the muscles and ligaments.
Physical therapy for valgus deviation consists of rehabilitation exercises for the legs, some yoga exercises, techniques for activating points on the feet, working with applicators, restorative massage.
Additionally, nonsteroidal anti-inflammatory drugs are prescribed that reduce inflammation and relieve pain in the affected joint. There may be warming anti-inflammatory ointments, creams and compresses, but all treatment should be under the supervision of an orthopedic surgeon. It is not recommended to self-medicate with the “bone” on the leg.
Surgical treatment of bone deformities on the leg
If the metatarsal bone has shifted quite significantly and cannot be restored to its normal position by therapeutic methods, surgical intervention is recommended. The type of operation is chosen by the attending physician. This takes into account comorbidities of the patient, the degree of deviation of the finger from the normal position, the presence of secondary deformities of the foot and toes.
There are 2 types of surgery for valgus deformities: reconstructive surgery and mini-invasive surgery. It is very easy to determine whether or not an operation should be done - if the “bone” interferes with walking and rubs your shoes, then you cannot do without intervention.
- clinical blood test,
- general urine analysis,
- blood chemistry,
- blood type and Rh factor
- blood tests for viral hepatitis, syphilis and HIV.
Special preparation for surgery on the foot is not required.
This type of surgery is performed with valgus deformity of the first degree. The operation is performed without skin incisions. Several small punctures are made through which the instruments are inserted - microscalpel, special cutters and others. Under X-ray control, the metatarsal and phalangeal bones are filed in the right places, the growth is removed, the physiological position of the joint is restored, the toe is returned to its place. After surgery, no fixation is needed - neither external nor internal in the form of plates and staples.
This type of treatment is carried out in the 2nd and more stages of deformation. Another name is osteotomy, or “bone excision.” The operation is more traumatic, but for many it becomes the only way out.
Osteotomy is carried out in an open way, with a dissection of the skin and the joint capsule. The “bone” is removed, the bulging I metatarsal bone is filed. The more pronounced the deviation of the bone, the more difficult and more bulky the cutting will be. The filing of the thumb phalanx is also carried out. Then the bones are given their normal position and fixed from the inside with titanium mini-screws.
After surgery, a fixation bandage is needed, crutches and other devices are not needed. Removal of titanium screws is not required. In the hospital, the patient needs to spend 1-2 days. Walking allowed in the first postoperative days. It is recommended to wear orthopedic shoes for several months. Puffiness of feet lasts up to 3 months.
Possible consequences of "bone" on the big toe
If the resulting growth on the foot is left without treatment, the violation will only progress. In addition to the cosmetic defect and problems with the selection of shoes, the possible consequences for the whole body.
From the side of the damaged foot, the rest of her fingers are curved, the ankle is deformed, and the heel spur can develop. Mowing the foot while walking causes damage to the knee and hip joints. The leg becomes X-shaped, the knee is turned inside out. The pelvis twists and becomes oblique, the position of the spine is disturbed, its sections are curved, the vertebrae are displaced. All this provokes the development of intervertebral hernia and clamping of the vertebral nerve roots.
Prevention of "seed"
In order to prevent the development of such an unpleasant and dangerous pathology, it is necessary, first of all, to protect your feet and give them enough attention. You can not wear tight shoes that squeeze the foot. It is advisable to buy shoes from elastic materials that stretch when worn. Women should wear a heel no higher than 5-7 cm. When playing sports with a large load on the legs and feet, it is necessary to pick up sports shoes with a thickened sole, which gives good cushioning.
It is useful to walk barefoot in the summer - this gives the foot its physiological position and prevents flat feet. To relieve fatigue and improve blood circulation in the feet, it is useful to do physical exercises - stand on toes, transfer weight from toe to heel, gently knead the foot - it strengthens the small muscles and prevents the bones from moving further.