Bone on the big toe
- The causes of the appearance of a bone on the big toe
- Symptoms of "bones on the leg"
- Therapeutic treatment of bone deformities on the leg
- Operative treatment of bone deformity in the leg
- Possible consequences of "bones" on the big toe
- Prevention of "bones"
The deformation of the foot, which was popularly called the "bone on the leg," is a deviation of the thumb from its normal physiological position. Of the 100 patients who are diagnosed with this disorder, approximately 85 are women and only 15 are men. In medicine, the bone is called valgus deviation, or Hallux Valgus.
The causes of the appearance of a bone on the big toe
Appearance of the stone on the leg may be preceded by changes in the structure of the foot, which remain virtually unnoticed until a noticeable cosmetic defect develops. Among the causes of valgus rejection of orthopedic causes are:
- Transverse flatfoot;
- Curvature of the posterior foot;
- Divergence of the first and second metatarsal bones, an increase in the angle between them;
- Contracture or contraction of the Achilles tendon;
- Reinforced with sports and dancing with a heavy load on the feet;
- Looseness of the I metatarsus-phalangeal joint;
- Paralysis of small muscles of the foot;
Work stops when walking. The main support points move, the load is redistributed, and a subluxation occurs in the region of the I metatarsal-phalangeal joint. The head of the metatarsal bone is shifted to the side, it protrudes under the skin, a bone-cartilaginous outgrowth begins to develop around it. This is how the "bone" is formed.
The thumb also begins to warp due to subluxation - it deviates in the opposite direction and is superimposed on the other toes of the foot. Without timely treatment, the foot can acquire a frightening, altered form, which is difficult to fix.
Especially contributes to the development of valgus deviation of women's love for narrow tight shoes with high heels. When walking in such shoes, the body weight is transferred to the front part of the foot, which leads to deformation of metatarsal joints. An increased risk of bone development is also observed in athletes and ballet dancers because of the burden on the soles of the feet. One of the risk factors for the development of the "bone" can be past injuries of the legs, which violated the normal position and work of the feet.
Symptoms of "bones on the leg"
The first symptom is the deviation of the big toe inwards. This is how you can distinguish valgus deformation from gout and other joint diseases. The longer the disruption remains without treatment, the greater the deflection of the thumb; Then it is superimposed on the II and III toe.
Then there is a lump - protrusion of metatarsal bone under the skin. Around the head of this stone begins to be deposited calcium salts, further increasing the bulge and causing discomfort. Further, a pain symptom is added - the bone hurts from rubbing with shoes, and later also at rest. Because of the looseness and deformation of the I metatarsus, the phalangeal joint develops inflammation, the surrounding tissues swell, further exacerbating the pain. Redness of the skin in the joint area can go to local purulent inflammation.
The affected foot becomes flatter, the patient is disturbed by the gait, the foot begins to slope to the inside when walking. Visually, the legs seem curved, and the foot - turned out. Hardly having noticed on a leg the changed joint, it is necessary to address to the expert for consultation and treatment.
The diagnosis of "valgus deformity" can be made on the basis of visual examination and collection of anamnesis, but to specify the radiograph of the foot in the direct and lateral projection. In the picture, a subluxation of the I metatarsal-phalanal joint becomes apparent, the angle of valgus deviation of the finger and metatarsal bone is determined. In parallel, differential diagnosis is performed with gouty joint changes, arthritis and arthrosis; Associated diseases, if any.
There are 4 stages of development of a "bone" on the big toe:
- 1 stage - the angle of deviation of the thumb from the normal position does not exceed 20 °;
- Stage 2 - displacement angle from 20 to 30 °;
- Stage 3 - from 30 to 50 °;
- Stage 4 - more than 50 °.
Therapeutic treatment of bone deformities on the leg
Diagnosis and treatment of valgus deformities of the feet is handled by an orthopedic doctor. At an early stage, when the first signs of displacement appear, conservative methods of treatment are possible. The simplest therapeutic measures include:
- Wearing orthopedic insoles, which help to eliminate flat feet;
- Correct mode of work and rest;
- If the occupation of the patient is related to the load on the legs, it is recommended to take a break or change the type of activity;
- Women are forbidden to wear shoes with stilettos (the heel should not be more than 7 cm) and shoes that squeeze the foot.
It is possible to assign special tie bands and silicone interdigital inserts. These devices return the thumb to its physiological position, and with prolonged wear can brake further deformation of the feet.
It is very effective to wear orthopedic insoles. Insoles are made with an order, individually for each patient. At the "bone" on the leg, the insole is formed using the instep support, which supports the transverse arch of the foot. Due to this, the load on the foot is distributed correctly, the foot does not slip to the side when walking.
In modern medicine, several technologies have been developed that increase the effectiveness of the treatment of "bones". Curvature, they do not eliminate, but can serve as a preparatory stage or an auxiliary measure to a more thorough treatment.
Shockwave therapy is an apparatus method for treating valgus abnormalities, flat feet, heel spurs. With the help of acoustic shock waves in tissues, blood flow becomes more active, nutrition improves, and damaged cells are restored and renewed.
As a result, calcium deposits in the area of the "bone" are destroyed - the formed growth is much less in 5-6 weeks of therapy. Increases the elasticity of the muscles and ligaments of the foot, pain and swelling disappear, inflammation in the area of the deformed joint decreases.
Therapeutic massage with valgus deviation removes the excessive tension of the small muscles of the foot. During the course of massage, the joint is tried to restore its physiological position, increase its mobility, eliminate overload and discomfort. With severe inflammation of the I-metatarsal, the massage is contraindicated!
The corrective orthopedic tire is designed for a long period of wearing - the first effect of its application is visible after 1-2 months. The valgus tire pulls the big toe, returning it to the correct position. Additionally, it corrects the transverse arch of the foot, raising it. The tire is worn constantly, it can not be removed during sleep. The mobility of the foot is preserved.
Laser therapy with a "bone" on the leg is the heating of the inflamed area with a laser. Due to the thermal effect, calcium deposits are destroyed, edema decreases, painful sensations are removed. The strained muscles of the foot relax, spasms are removed.
Ultrasonic therapy has the same thermal effect that relaxes the small muscles of the foot and triggers active blood flow in the vessels and capillaries, facilitating the recovery of cells and tissues. In addition, ultrasound promotes the production of collagen in tissues, so the elasticity of the foot increases, muscles and ligaments are strengthened.
Therapeutic exercise with valgus deviation consists of rehabilitation gymnastics for the feet, some exercises of yoga, receptions for activation of points on the feet, work with applicators, restorative massage.
In addition, non-steroidal anti-inflammatory drugs are prescribed, which reduce inflammation and relieve pain in the affected joint. Possible warming anti-inflammatory ointments, creams and compresses, but all treatment should be under the supervision of an orthopedic doctor. Do self-medication with a "bone" on the leg is not recommended.
Operative treatment of bone deformity in the leg
If the metatarsal bone has shifted already quite significantly and the therapeutic methods can not restore its normal position, surgical intervention is recommended. The type of operation is chosen by the attending physician. This takes into account the concomitant diseases of the patient, the degree of deviation of the finger from the normal position, the presence of secondary deformities of the foot and fingers.
There are 2 types of surgery for valgus deformities: reconstructive surgery and mini-invasive surgery. Determine whether or not to do the operation, it is possible very simply - if the "bone" prevents walking and rubbing in the shoes, then there is no way to do without intervention.
- clinical blood test,
- general urine analysis,
- blood chemistry,
- Blood group and Rh factor,
- Blood tests for viral hepatitis, syphilis and HIV.
Special preparation for operation on the foot is not required.
This type of surgery is performed with valgus deformation of the I degree. The operation is performed without skin incisions. Several small punctures are made, through which the instruments are introduced - microscalpel, special cutters and others. Under X-ray control, metatarsal and phalangeal bones are filed in the right places, the growth is removed, the physiological position of the joint is restored, the big toe of the foot returns to its place. After the operation, 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 stage of deformation. Another name for it is osteotomy, or "excision of bones". The operation is more traumatic, but for many it becomes the only way out.
Osteotomy is performed in an open manner, with dissection of the skin and articular capsule. The "bone" is removed, the protruding I metatarsal bone is filed. The more pronounced the deflection of the bone, the harder and more extensive the cutting will be. The phalanx of the thumb is also filed. Then the bones are attached to their normal position and fixed from the inside by titanium mini screws.
After the operation, a fixative bandage is needed, crutches and other devices are not needed. Removal of titanium screws is not required. In a hospital the patient needs to spend 1-2 days. Walk permit already in the first postoperative days. It is recommended to wear orthopedic shoes for several months. The swelling of the feet lasts up to 3 months.
Possible consequences of "bones" on the big toe
If the resulting outgrowth on the foot is left untreated, the disturbance will only progress. In addition to a cosmetic defect and problems with the selection of shoes, the consequences for the whole organism are possible.
On the side of the injured foot, the curvature of the rest of her fingers is observed, the ankle joint is deformed, the calcaneal spur can develop. The mowing of the foot during walking leads to knee and hip joints. The leg becomes an X-shaped, the knee turns inside. The pelvis twists and becomes oblique, the position of the spine is disrupted, its sections are bent, the vertebrae are displaced. All this provokes the development of intervertebral hernias and the clamping of the roots of the vertebral nerves.
Prevention of "bones"
To prevent the development of such an unpleasant and dangerous pathology, you need, above all, to protect your feet and pay enough attention to them. Do not wear tight shoes that squeeze the foot. It is desirable to purchase shoes from elastic materials that stretch when worn. Women should wear a heel no higher than 5-7 cm. When practicing sports with a heavy load on the feet and feet, one must choose athletic shoes with a thickened sole that gives a good cushioning.
It is useful to walk in the summer barefoot - it returns the foot of its physiological position and prevents flat feet. To relieve fatigue and improve blood circulation in the feet it is useful to do physical exercises - to stand on socks, to carry weight from the toe to the heel, to gently knead the foot - this strengthens the small muscles and prevents the displacement of the bones in the future.