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Leg surgery to remove bunions

08 Jun 18

The success of your operation largely depends on how strictly you follow the recommendations of your attending physicians!

The operation is performed using the Chevron method, taking into account the unique developments of our clinic. With this intervention, iron pins are not used and repeated operations to remove them are not required. The seam remains very small and in a year it will not be visible .

At the patient's request, removal is performed under local anesthesia or general anesthesia . General anesthesia is short, venous. You will wake up after it in 1.5-2 hours, you will be able to stand on your leg almost immediately, and the operation to remove the bone lasts 30 minutes.

At the request of the patient, the operation can be performed on 2 legs simultaneously, or in turn. If you decide to operate on one leg first, then the other, then the second leg can be operated on in six months to a year, depending on your desire. Some patients come back within two months for surgery on their second leg.

Recovery after surgery Hallux valgus - bunions

In our clinic you will be able to stand on your leg almost immediately after surgery! The uniqueness of the method allows you NOT to use special shoes, which are usually suggested with other methods. You can even do without crutches . There will only be a bandage on your leg, you will be asked to stand up 1.5 hours after the operation, the attending physician will show you how to walk correctly and will help you “get back” to your feet.

In the first days after surgery, the load on your legs should be dosed to speed up recovery and eliminate side effects: in the first three days you can walk for about 5 minutes a day, correctly leaning on your leg (the doctor will tell you how to do this). Then the load is increased by 5 minutes per day. After 10 days you can “go out in public” or go to work. Of course, the speed of recovery after Hallux valgus also depends on the personal characteristics of the body, age, state of immunity, the ability of leg tissue to heal, and the presence of concomitant diseases.

For information: an operation to remove a lump can be performed in any city and in any country (including Russia, Europe, and Israel), and even for free - since this operation is included in the municipal list of free operations. But this will be the usual classical technique, possibly with iron pins that will have to be removed; with the obligatory wearing of special shoes for several weeks (Baruk shoes) and subsequent use of crutches. And the recovery process will be long, up to six months. Our technique is unique , it is performed by only three surgeons in the world, two of them in our clinic.

Removal of bunions is performed under local or general anesthesia; if desired, you can operate on two legs at once. After removal, the bones no longer grow and do not hurt, it becomes much easier to walk on your feet, the pain and discomfort go away.

After hallux valgus surgery, you can (optional) stay in the clinic for 1 night or return to the hotel. The next day, the attending physician performs a follow-up examination and administers another local anesthetic. Throughout the postoperative period, you will need anti-inflammatory drugs, which will be prescribed to you by your attending physician.

The stitches are removed after 10 days , leaving no scars. After a year, you will not even be able to determine the place where the incision was made.

Immediately after Hallux valgus surgery, you will need loose shoes to fit your foot in the cast. Summer sandals with Velcro fasteners (available in sports stores) or any other loose shoes for your feet will do. If you had bunions with 3 or 4 degrees of Hallux valgus, be prepared for the fact that the shape of your feet will change and your previous (especially narrow-toed) shoes will no longer suit you! In order to prevent the bunion from returning again, it is recommended to wear the “correct” shoes: with a heel no higher than 4-5 centimeters and with the correct toe shape - rounded, straight, not pointed and with the most straight line along the inner edge of the shoe. Of course, you can walk in high heels, but it is not recommended to do this every day because it is harmful to your new and beautiful bunionless foot! Since healing and formation of the joint after surgery will occur within a year, for this period it is recommended to wear the most loose and comfortable shoes with heels no more than 2-3 centimeters. In the future, restrictions can be completely abandoned.

Bunions are a common problem for women; for example, wearing high heels can cause bunions to appear on your feet. There are several types of operations, but our surgeons use a unique method of operation. Removal of bones can be performed either on 2 legs at once, or first on one leg, then, after a few months, you can come for surgery on the other leg.

Leg surgeries, bone removal

After the operation, it is recommended to protect your foot from bruises for a year, so it is better to wear closed shoes, and it is also advisable to wear shoes that are loose enough for your feet. Don't run (yet), don't jump! You just walk, gradually increasing the load and developing the capabilities of the joint. Also, for complete foot health, it is recommended to wear special orthopedic (preferably made individually for you) insoles. If you follow the recommendations, the bone will no longer bother you and subsequent removal operations will not be required. Once you have the surgery, you will be very happy with your feet!

Today, bones are a fairly common reason for patients turning to surgeons. Operations to remove them are carried out using various methods, but do not always bring the desired result, which is associated with a long recovery period and a number of side effects. If there is such a problem, then the bone needs to be removed; conservative treatment of the bones is practically pointless. In our clinic, leg surgeries are elective with a low level of side effects and no complications. For many patients, such an operation is the only alternative to get rid of the continuously accompanying discomfort in the legs. The result will bring you satisfaction!

If you have any questions before or after Hallux valgus surgery , you can always contact us by phone and talk to a specialist!

  • Russia: +7 (927) 247 28 28 (organizational and general questions)

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      Surgery to remove bunions on legs

      In medicine, bunions in the lower extremities are called hallux valgus. Removal of a lump on the leg is carried out in the last stages of the pathology, since it brings a number of inconveniences to the patient, including severe pain when walking. Cones can be removed using various surgical interventions; the choice of one of the methods is made by the attending doctor.

      Removal of bunions on the leg bones is resorted to in extreme cases, when gentle measures do not produce results.

      Indications for use

      Hallux valgus deformity has several degrees, which are classified according to the angle of the deformity. Removal of the bunions is required only at the last stage of the pathology. During it, patients complain of the following symptoms:

    • the angle of finger displacement becomes more than 50 degrees;
    • pain in the foot is observed both at rest and during movement;
    • the joint thickens;
    • calluses form under the finger.
    • If we talk about the early stages of hallux valgus, then surgical treatment is required in situations where traditional therapy has not produced the desired effect. They resort to surgical interventions at the request of the patient.

      When is surgery not performed?

      Removal of a bunion on the big toe is not resorted to in situations such as:

    • diabetes;
    • disruptions in the clotting of blood fluid;
    • excessive body weight;
    • dysfunction of the cardiovascular system;
    • inflammation of the vein with the formation of a blood clot;
    • impaired blood supply to the feet.
    • Return to contents

      How to prepare for surgery?

      Before operating on the patient, an x-ray is taken, which is performed in several projections in order to obtain the most complete picture of the joint deformation. Sometimes magnetic resonance imaging is required, which gives more accurate results. After this, the patient is sent for a general examination of urine and blood, and bacterial culture. Fluorography and cardiogram, standard for all operations, will also be required. A week before surgery, people will need to resort to special foot baths. In addition, doctors prescribe a number of medications, which are selected depending on the individual characteristics of the patients.

      Methods and progress of operations

      When removing the lump, partial resection is used. Before the operation begins, the patient is given general anesthesia. This method of surgical intervention is used when the angle of deviation of the first toe is more than 13 degrees. During the manipulation, the doctor cuts off the muscle that abducts the thumb. After removing a bunion using this method, complications sometimes develop. The risk of infection, nerve and joint damage cannot be ruled out. Sometimes hallux valgus can develop again, requiring repeat surgery. In addition, after osteotomy, aseptic necrosis of the bone head may occur.

      How to remove a lump using a laser?

      The bone on the foot near the big toe is excised with radiation. This reduces the likelihood of injury and speeds up recovery after the intervention. After this procedure, there is no need to apply a splint, which is another advantage. 3 hours after the manipulation, the patient can go home, he is even allowed to lean on the limb where the intervention was performed. As for rehabilitation, the damaged finger is restored after 21 days. This is facilitated by various exercises and gymnastics, which the doctor introduces to the patient.

      McBride intervention

      Before the bump on the leg is removed, the person is given local anesthesia. The specialist then makes an incision in the foot. Separates the muscle that is attached to the first phalanx. It is cut and shortened, and then sewn to the bone. If the case requires it, they resort to excision of other muscles. Because the muscle tissue is stretched, the affected joint begins to straighten over time. At the end of the intervention, the incision is sutured and a plaster is applied, which is removed after 3 weeks.

      The operation to remove a bunion can be performed either in a hospital or on an outpatient basis, without requiring hospitalization of the patient. Before the intervention, the affected foot is treated with iodine, and then the patient is given local anesthesia. During the operation, the doctor makes an incision, the length of which is 5 cm, after which he bends the tissue adjacent to the bone. The protrusion is knocked down with a chisel, and the surface of the bone is polished. The removed tissues are returned to their place and stitched. A special roller is placed between the thumb and the next finger, which is fixed with glue. At the end of the intervention, a splint is applied to the injured foot.

      Hochman intervention

      Anesthesia is carried out using intraosseous injection of novocaine. The specialist makes an incision near the first phalanx, removes the mucous bursa and removes the tendon that is attached to the phalanx. The doctor, using a chisel, knocks out a piece from the bone of the thumb, with the help of which the articular axis is aligned. A wire is attached to the remaining bone, then the exostosis is cut off. The tendon is shortened and then sewn to its usual place. The incision is sutured and plaster is placed on top. You will need to walk with it for at least 21 days.

      Wreden-Mayo intervention

      They mostly use local anesthesia, but surgery to remove the lump can also be performed under general anesthesia at the request of the person. During the manipulation, the doctor makes an incision and excises tissue. A special tool is then used to dislocate the bone. The cutting is done using a saw. At the end of the operation, the doctor polishes the bone and sutures the incision, over which he places a splint. Unlike the previous method of intervention, during the Wreden-Mayo operation, a large amount of bone is removed.

      Reconstructive intervention using the CITO method

      Surgery on the bunion of the big toe is performed together with an osteotomy. Local anesthesia is usually administered before the procedure. The doctor makes an incision and excises tissue. Then an osteotomy of the thumb bone is performed, the area is removed, and an autograft is installed inside it. The bone is secured with knitting needles, which must be removed after a certain time. The muscles of the thumb are shortened, subsequently a tension is observed that will hold the bone in the desired position. At the end of the procedure, the doctor sews up the incision and applies a cast, which is removed after a month and a half.

      Rehabilitation after bunion removal

      Rehabilitation after removal of a cone on the leg is directly related to the amount of tissue removed. On average, recovery takes about 2 months. Doctors draw patients’ attention to the fact that it is important not to put any weight on the injured foot during the entire postoperative period. To do this, it is recommended to purchase crutches and adhere to bed rest. When several months have passed after the operation, patients will need to follow the following rules:

    • Wear special comfortable shoes. It is important that its base is quite wide, which will reduce the load on the thumb. In addition, it is recommended to install orthopedic insoles in shoes.
    • Take medications prescribed by your doctor. Most often they resort to antibacterial, anti-inflammatory and analgesic pharmaceuticals. The most popular medicine is Nise. The medication is produced in the form of tablets, which are taken until the wounds are completely healed, and a gel, used at the final stage of rehabilitation.
    • Do gymnastics. The exercises that the patient will need to perform are determined for each person individually by the treating healthcare professional. Doctors note that often after surgery to remove a lump, the finger swells, so you can start doing gymnastics only after the swelling disappears.
    • Exercise during recovery is important to reduce the risk of inability to flex and extend the thumb due to scarring.

      What are the complications?

      The most common consequence of surgical removal of a lump on the leg is a violation of the sensitivity of the skin in the place where the manipulation was performed. This is mainly a temporary phenomenon that disappears a year after the intervention. This condition is caused by the fact that branches of the nerves are often damaged during the operation. If they completely intersect, then sensitivity never returns or decreases quite significantly. Sometimes patients' wounds do not heal for a long time, so doctors prescribe the use of anti-inflammatory medications.

      Sometimes people note the occurrence of sharp pain that occurs when moving. They are formed due to displacement or incorrect installation of the screw. You can get rid of this condition by repeated intervention and removal of the screw. The development of bone necrosis, which can occur with any surgical intervention, is also noted. Recurrence of hallux valgus is also possible. This applies more to minimally invasive interventions. An equally common complication of removing a lump on the leg is decreased joint mobility. In this case, the patient will need to perform special exercises prescribed by the treating specialist. Sometimes you need training on simulators in a medical facility.

      Surgery to remove a bunion on the big toe

      Removal of a bunion on the big toe is a surgical method of treating hallux valgus, which is popularly called a “bunion” or “bump.”

      Conservative treatment of this common pathology is effective only at the initial stage of the disease, when the thumb deviates slightly (up to 15 degrees) outward, there is no pain yet, and the lump itself looks like a small tubercle.

      If a bunion appears on the leg, timely contact with an orthopedist allows you to correct the deformity using conservative methods

      Unfortunately, not all people pay attention to changes in the foot before pain symptoms appear, and the doctor examining the patient is forced to state that the situation is advanced and only removal of the bone on the big toe can correct the pathology (the operation allows not only to get rid of pain and prevent the progression of the disease, but also to restore the arch of the foot).

      Types of surgical treatment for bunions

      The operation to remove a bunion is carried out after additional diagnostics, which allows you to accurately assess the degree of deformation and identify concomitant pathologies and diseases.

      The choice of surgical technique (there are about 100 different methods) is influenced by:

    • type of deformation;
    • the condition of the bones and soft tissues of a particular patient;
    • presence of somatic diseases.
    • Since low-traumatic methods and modern anesthetics are currently used in most cases to remove bunions, the age of the patient does not affect the choice of surgical procedure.

    • Osteotomy, which is used in most cases as the most effective method. With any type of osteotomy, during surgery, the tissue is cut over the deformed joint, the bone is intersected (transversely closer to the nail or at its other end, Z-shaped or along the main phalanx), bone fragments are installed in the correct position and fixed with staples or a special screw.
    • Arthrodesis. This type of surgery is performed in very rare cases, since the main purpose of the operation is to create a fixed joint that does not allow the foot to be completely restored. The indication for this type of operation is a severely damaged thumb joint, which cannot be returned to the correct position using osteotomy. During the operation, the metatarsophalangeal joint is removed, and the bones are connected to each other. The disadvantage of this method is the pain at the fusion site that occurs after exercise, as well as the need to constantly wear orthopedic shoes.
    • Resection arthroplasty, in which part of the articular surface is removed. In this case, a cavity remains between the parts of the bone, which is filled with connective tissue during the healing process (thus forming a false joint). This operation does not provide complete restoration of foot function.
    • Correction of the transverse arch of the foot. With this type of surgery, it is not the joint and bone that are corrected, but the soft tissue around the problem area. During the operation, the tendons of the adductor hallucis muscle are transplanted from the big toe to the 1st metatarsal bone, the muscle no longer holds the big toe in a deflected position, the angle between the bones of the foot changes, and the arch of the foot restores its normal shape. The method is effective in the early stages of the disease.
    • Exostectomy, in which the cone itself (part of the head of the metatarsal bone) is excised, as well as the soft tissue located around the affected joint. The gait after the operation is restored, the pain is eliminated, but relapses are possible.
    • Common techniques

      Surgery on the bunion of the big toe with the intersection of the bone is most often performed using the method:

    • Scarf osteotomy. Used for moderately severe hallux valgus deformity. Allows you to shift in the longitudinal direction and rotate part of the head of the metatarsal bone, lengthen or shorten the first metatarsal bone, shift bone fragments, which allows you to achieve greater proportionality of the joint and reduce the load on the joint and the inside of the foot. The technique gives good results in combination with soft tissue correction.
    • Austin/Chevron osteotomy, in which a V-shaped transection of the first metatarsal is performed. Used in cases of minor valgus deformity, it allows the head of the metatarsal bone to be displaced by 1/2 of its width (if the displacement is more than 1/2 of the width of the bone, the stability necessary for bone fusion may not be enough).
    • Akin osteotomy, which is performed on the main phalanx (at the level of the proximal part of the tubular bone adjacent to the epiphyseal plate). Accompanied by mandatory manual correction of hallux valgus. The bone is divided parallel to the metatarsophalangeal joint and the nail bed of the big toe, and the wedge-shaped fragment is removed.
    • Various methods of cutting the bone when removing a bunion.

      Surgery to remove a bunion on the big toe can also be performed:

    • According to the Weil method (oblique osteotomy of the small metatarsal bones). Allows you to move the bones towards the center and in the longitudinal direction, returns the head of the metatarsal bone to its normal position and helps eliminate hammertoe deformity.
    • According to the Schede-Brandes method (marginal resection of the medial bone outgrowth (exostosis)). During the operation, the bone on the lateral surface of the 1st metatarsal bone and the proximal part of the main phalanx of the big toe are removed, a plaster splint is applied to fix the foot in a certain position, and then traction is performed on the nail phalanx of the big toe for 2 weeks.
    • A good cosmetic result is obtained by surgery to remove bunions using the Wreden-Mayo method (consists in removing the head of the 1st metatarsal bone along with the bump), however, due to the elimination of the main supporting platform of the foot when walking, a violation of the supporting function of the foot is observed after the operation.

      Removal of the bunion on the big toe using the Chalkin method (intersection of the bone with rotation of the head of the 1st metatarsal bone) and trapezoidal wedge resection of the 1st metatarsal bone using the Bohm and Reverden method do not eliminate the medial deviation of the 1st metatarsal bone and do not restore the arch of the foot, therefore, they are often accompanied by relapses.

      The patient may be offered reconstructive surgery aimed at correcting several components of the foot deformity:

    • The method of Kramarenko and Boyarskaya, during which, after surgery using the Schede-Brandes method, to eliminate the medial deviation of the 1st metatarsal bone, a transverse osteotomy is performed distal to the metatarsocuneiform joint, and a graft formed from previously removed parts of the bone is hammered into the resulting wedge-shaped gap. A transverse ligament of the foot is formed from Mylar tape, which holds the 1st metatarsal bone in the correct position (the tape is sutured to the edges of the capsules of the 1st and 5th metatarsophalangeal joints). After surgery, a plaster cast is applied to the foot for 4-5 weeks.
    • Operation Korzh and Eremenko, in which the bone does not intersect, since the defect is eliminated by removing the 1st metatarsocuneiform joint. The transverse ligament of the foot is formed from the tendon of the long extensor of the 4th toe.
    • An operation using the CITO method, which is accompanied by the formation of a transverse ligament of the foot from a Mylar tape in the form of a figure eight according to Klimov.
    • Performing an operation using traditional surgical methods.

      If necessary, endoprosthetics is performed, in which the deformed joint is completely removed and replaced with an artificial one.

      How is a bunion removed?

      Previously, surgery to remove a bunion on the big toe was quite traumatic (the bunion was removed, the joint was secured with staples and pins), so complications often arose, and the rehabilitation period was long. Due to the imperfection of previously used techniques, reviews of the operation to remove bunions were rather negative, since the high level of trauma accompanying the surgical intervention caused pain in patients for a long period, and relapses were often observed.

      Currently, bunions can be removed with minimal trauma using:

    • Minimally invasive techniques in which the incision does not exceed 3 mm (with significant deformation - 10 mm). Surgical manipulations (intersection of the bone and displacement of its parts) are carried out through this small incision under X-ray control. The advantages of minimally invasive osteotomy include a short rehabilitation period and almost invisible scars, pain and the risk of complications are minimal. Minimally invasive operations do not require general anesthesia (local or epidural is used), but can only be used for mild deformities of the thumb.
    • A laser that allows you to remove bone tissue in the thinnest layers, thus maintaining joint mobility. The rehabilitation period is shorter than when using a traditional surgical kit (drill, knitting needle, screwdriver, clamp). Laser removal of bunions is used if the patient does not have other foot deformities or complications of hallux valgus.

    Minimally invasive and traditional methods that are used for various types of hallux valgus.

    Access during the operation can be:

  • open (the tissue is cut to the bone using a scalpel, the surgeon, thanks to a visual review, controls the correction process);
  • closed (manipulation is carried out through a small incision, control is carried out using x-rays).
  • Laser bunion removal involves grinding down the bunion on the foot until it is completely aligned with the lateral surface of the foot, which is carried out through a small incision. To remove a bone using a laser, resurfacing is accompanied by:

    The advantages of laser removal of hallux valgus include:

    • disinfection of the wound under the influence of a laser, which minimizes the risk of infection;
    • minimal blood loss due to the small size of the incision through which manipulations are performed;
    • no effect on surrounding tissues;
    • fast recovery;
    • shorter operation time (takes 1 hour, while removal of a lump using traditional surgical methods takes about 2 hours);
    • no need to wear a cast after surgery.
    • The most minimally traumatic and effective method is to remove a bone on the thumb using a laser.

      Removing a bunion using any method consists of several stages. Most often during the operation:

    • An incision is made on the inside of the big toe phalanx.
    • A capsulotomy is performed (dissection of the capsule of the first metatarsophalangeal joint).
    • Excision of the bone outgrowth (bump removal) is performed.
    • The first bone of the metatarsus is sawed (an osteotomy is performed).
    • The surgeon moves fragments of the metatarsal bone, changing the axis of the deformed area.
    • The bone is fixed with titanium screws or staples.
    • The capsule and incision are sutured.
    • A sterile bandage is applied to the access site.
    • A fixing bandage or plaster is applied to the foot (depending on the type of operation).
    • Titanium screws are not removed if there is no discomfort.

      Although leg surgery to remove a bone is usually performed using low-traumatic techniques, there are a number of contraindications to its implementation. The operation is contraindicated for:

    • thrombosis, which is accompanied by inflammation of the veins and bleeding disorders;
    • diabetes mellitus, obesity;
    • cardiovascular failure;
    • poor circulation of foot tissues;
    • pathologies of the musculoskeletal system.
    • Removing a bunion with a laser has virtually no contraindications, but a preoperative examination is necessary before the procedure.

      Preparing for surgery

      Before removing bunions, it is necessary to undergo a thorough diagnosis to identify all pathologies of the foot - x-rays of the foot from different sides or magnetic resonance imaging.

      In addition to removing the big toe bunion, surgery may include eliminating hammertoes in other toes, etc.

      As part of the preoperative examination, the patient is sent for tests:

    • blood (general, biochemical, sugar, clotting);
    • urine (general analysis);
    • to detect hepatitis and HIV;
    • ECG;
    • fluorography.
    • Approximate cost of the operation

      Since free hallux valgus surgeries in public institutions require a referral from an orthopedist and a wait in line for elective surgery, patients are often interested in how much it costs to remove a bunion.

      The cost of the operation is influenced by the qualifications of the doctor, the methodology, the status of the clinic (private, municipal), the equipment and drugs used. On average, the price varies from 200 to 1000 dollars (in metropolitan areas the cost of the operation is higher than in the regions).

      Since the cost of surgery is influenced by many factors (including payment for anesthesia, etc.), it is necessary to call the clinic to clarify the information. Before removing a bunion on your big toe, you must consult with the surgeon of your chosen clinic about possible options for the operation.

      The cost of laser bunion removal is higher than other surgical methods.

      The duration of the rehabilitation period depends on:

      In any case, fixation of the foot is required during the postoperative period. If only part of the metatarsal bone was removed from the patient and the operation was performed without the use of a laser, the foot is fixed for 4 weeks; if the joint is removed, this period increases to 10 weeks.

      Rehabilitation after minimally invasive or laser surgery takes less time and, judging by reviews, proceeds more smoothly.

      The load on the foot in the postoperative period is limited, walking is allowed on average after a week (the pressure on the operated foot is limited). Normal walking is allowed after consultation with your doctor (on average after a month). With Scarf osteotomy, loads on the foot are allowed in a special orthosis immediately after the operation.

    • complex therapy (antibacterial, anti-inflammatory and painkillers);
    • physical therapy complex, which the doctor selects on an individual basis;
    • wearing soft, wide shoes with tight arch support or special orthopedic shoes;
    • wearing orthopedic insoles.
    • Exercise therapy is always prescribed in the postoperative period, but the timing of its initiation depends on the method of operation:

    • During the Schede-Brandes operation, therapeutic exercises are carried out from the 4th, 5th day after the operation. The patient is then advised to constantly wear an insert that holds the 1st finger in the correct position.
    • When using the Kramarenko and Boyarskaya operations, exercise therapy begins for the 1st toe on the 5th day. After removing the fixing plaster cast, the forefoot is fixed with a rubber cuff that supports the transverse arch.
    • When using the CITO technique, plaster immobilization lasts 1-1.5 months. Exercise therapy begins on the 4th and 5th day after surgery.
    • Exercises in the postoperative period are similar to those used to prevent hallux valgus.

      Judging by patient reviews, after removing bunions using modern surgical methods, the deformity does not return, and complications are extremely rare. Patients' quality of life significantly improves, pain disappears and they are able to wear regular comfortable shoes.

      When is bunion surgery necessary?

      Bunion surgery is a decision that involves pain and discomfort. The bone itself is not a disease, it is already its manifestation. As a result of the deformation, corns and calluses appear, but the most striking is the protruding joint on the thumbs.

      In medical parlance, the disease is called “valgus deformity of the thumb.” Symptoms include redness of the joint, its shine, swelling, and hardness to the touch. In fact, there are no so-called cones. It's an illusion. The visual effect is created due to the deviation of the metatarsal bone, which is part of the foot. Due to the outward deviation of the head of the bone, the appearance of a protruding lump is created.

      Causes of hallux valgus deformity

      Often the problem that appears is confused with arthrosis and gout. To determine the diagnosis, you need to see an orthopedic doctor. Visual examination, x-rays, and blood tests will make it possible to identify the disease. Even the slightest manifestations of deformation should not be ignored. Otherwise, the condition will gradually worsen, the bone will deviate more and more, which will ultimately disfigure the leg. In this case, increasing pain will appear when walking. Choosing shoes will become problematic, and you will have to forget about elegance.

      Based on statistical data, women are most predisposed to the disease. It is detected in them 20 times more often than in men. Doctors explain this by the fact that in the fair half of the population, the muscular-ligamentous apparatus is endowed with congenital weakness and increased elasticity. It is necessary to take care of your feet from childhood. However, the craving for beauty puts women on high heels, while the feet cannot withstand such loads, they are flattened and deformed.

      Another important factor is heredity. If someone in the female line has had this disease, then there is every reason to be at risk. The misconception is that this is an age-related manifestation. You can often find it in girls 12-15 years old. However, it is a known fact that the body stops growing only after reaching 25 years of age, which is why surgeons recommend surgical intervention to remove the bone after reaching this age. Deformation can be provoked by excess weight, injury, walking long distances, previous diseases of the cartilage tissue of the joint, or flat feet.

      When surgical intervention is necessary

      With constant uneven load on the foot, the muscle and ligament become weaker over time, and the arches, which are located between the bases of the toes and on the inner edge of the feet, sag and flatten. This deformation affects the metatarsals, which are normally parallel. When the foot flattens and becomes wider, and tight shoes continue to exert their detrimental effect, a gradual deviation of the metatarsal bone occurs and a valgus angle is formed, that is, a bunion. The apex of the angle thickens, and as a result there is a protruding bone that cannot be hidden.

      There are several stages in this process:

    • at the first stage, an unaesthetic appearance and a deviation of only 20 0 are noticeable;
    • with the second, this is accompanied by pain while walking and the displacement is already 20-30 0;
    • in the third stage, the pain is constant, it is problematic to choose shoes, and the angle of displacement is from 30-50 0;
    • during the fourth, pain and inflammation persist even at rest, the tilt exceeds 50 degrees, and the deformation extends to other joints.
    • To cure the disease, even at the first stage it is necessary to use physiotherapy, light exercises, and massage. Orthopedic insoles will help alleviate symptoms. If such methods do not have an effect, the pain persists, and it is impossible to choose shoes, there is only one way out - to agree to an operation to remove the bone.

      Types of surgical intervention

      There are more than 200 known surgical methods to get rid of a lump. Doctors use a scalpel to manipulate the soft tissue. In this case, the joint capsule is sutured, as it is stretched. The mucosa is excised, and the tendons are lengthened and transplanted. Thus, the designer’s method is used; doctors use the details to form a new foot. If more advanced stages of growth are identified, then operations on the bone itself are practiced. Combined methods are also known, when a scalpel is used for both soft tissues and bones. They are less traumatic, and rehabilitation is much easier.

      The theory of medicine mentions many types that have been tested for decades and can relieve illness. This is a Schede operation, which received its name in honor of Dr. Schede-Brandes. He developed the features of its implementation and successfully implemented them. Also surgery using the method of Wreden-Mayo, Boyarsky, Kramarenko and so on.

      Several decades ago, the bone cutting method was common. After which the joint was placed in the desired position and secured using a metal implant (wire, screw or plate). To accurately fuse the leg, it was cast. Naturally, the whole process is inconvenient and painful. Another disadvantage was that the operation was performed exclusively on one leg, and only after rehabilitation was it possible to operate on the second. Walking on crutches for up to 2 months and enduring pain is not a very interesting prospect. In addition, it is necessary to apply complex treatment for some time and remove the pins or screws, after which a recovery period also begins. To restore the flexibility of the big toe, a special brace is put on the foot and therapeutic exercises are prescribed. Recovery is long and difficult, but the method will make it possible to get beautiful fingers and avoid unforeseen consequences.

      The most famous methods today are:

    • exostectomy (part of the head of the metatarsal bone is excised);
    • osteotomy (parts of the bone are removed);
    • arthrodesis (the joints are fixed and become immobile);
    • resection arthroplasty (part of the joint is removed);
    • correction of the arch of the foot (ligaments located near the toes are restored);
    • endoprosthetics (deformed joints are completely removed and replaced with an implant).
    • Modern medicine does not stand still and it is possible to get rid of deformation without breaking a bone.

      A quick and virtually painless surgical procedure is performed using local anesthesia.

      After its administration, the doctor performs correction of ligaments, tendons, muscles and capsules. The correct foot is formed, the position of the toes is aligned, and the corrected result is to be consolidated. Sutures are placed on the operated foot, which are successfully removed after 5 days.

      After 24 hours, you can step on the entire heel, and after removing the stitches, you can step on the entire foot. After such foot surgery, the load must be increased slowly. You can fully perform all normal activities after 14 days, but you should avoid excessive activity. The foot will recover completely 45 days after surgery. You can even wear heels and dance.

      There is another modernized variation of the operation. Removal of bunions is carried out using a three-centimeter incision in the problem area. With its help, the doctor will move the tendon to the correct position. Transverse arches are also formed. Flat feet are corrected and the toes become straight. Under the influence of such manipulation, the cones disappear. Rehabilitation is easy, and it will be possible to restore the function of the leg without plaster applications and crutches within 21 days.

      In particularly advanced cases, valgus can be corrected only with the help of osteotomy. The procedure is performed by excision of bones. This is the most traumatic option, but the good news is that the fixation is carried out without steel knitting needles, but only with small screws. They are not removed later; they remain inside the leg. In this case, there is no need to perform another operation to remove them, then the recovery will not be as long as with the old methods of surgery. After excision, the sutures will not be removed so quickly; you need to wait two weeks.

      Consequences of surgical interventions

      Based on statistics, surgical methods for treating bunions in the legs give an excellent effect in 90 cases out of 100. However, not all patients can undergo such operations.

      There are a number of contraindications, upon identifying which the doctor may refuse surgical intervention:

    • the bone and joint are too deformed or inflamed (in this case, the inflammation is relieved first);
    • poor blood clotting;
    • disruption of any tissue function;
    • presence of general somatic diseases;
    • varicose veins;
    • disturbance of cardiovascular activity.
    • The effectiveness of the surgical route is high only if you follow all the doctor’s instructions. Wear shoes with wide toes, hard and high heels and tight arch support. Use orthopedic insoles. Protect your legs from unnecessary stress. Eat right if a diet is prescribed.

      Many clinics today also use the laser method of getting rid of the disease. Therefore, as soon as a problem is discovered, you should immediately consult a doctor. He will help you choose a gentle and effective treatment method. However, in advanced cases, surgery is the most effective method to get rid of bumps on the legs.

      Surgery to remove a bunion and recovery after it

      The appearance of a protruding bone in the area of ​​the big toes seems to many people to be just an aesthetic problem that does not pose a health hazard. This is actually a common foot condition. “Bones on the legs” is what people call this disease. Experts call this disease hallux valgus. Should I be concerned about this disease? What methods exist for removing bunions? This is what we will talk about.

      This pathology is primarily a cosmetic problem. Due to the deviation of the toe, the foot loses its shape and looks ugly. In addition, hallux valgus causes pathological changes in various structures of the foot (joints, ligaments, bones, tendons), which cause pain and difficulty walking. Surgery to remove a bunion can help alleviate the condition. The goal of surgery is to correct the deformity.

      Conservative treatment or surgery?

      When hallux valgus is detected, the question becomes how to get rid of this problem. First you need to seek help from a doctor. The specialist will issue directions for a series of examinations, the results of which will make it possible to clarify whether there is inflammation of the periosteum, cysts, arthritis or other changes. Depending on the degree of deformation, methods for removing bunions will be selected.

      However, in most cases, people suffering from hallux valgus delay their visit to the doctor . They come to a specialist when the process goes too far and the bones on their feet begin to cause a lot of problems. In such advanced cases, orthopedists prescribe surgical treatment for bunions.

      Don't be afraid of surgery. The operation is performed under local anesthesia. The surgeon changes the position of the big toes and forms the correct anatomical structure of the feet. A sick person who has undergone surgery is allowed to walk after a few days. After a week, you can move without restrictions, and 2 weeks after surgical removal of the bunions, specialists remove the sutures.

      Types of operations

      Several decades ago, hallux valgus was eliminated in ways that were more crippling. For example, a doctor would break certain bones of the foot, and then fix them with a metal structure. A cast was placed on the leg, and the person had to use crutches to move. Nowadays, doctors know how to remove a growing bunion without causing harm to the patient.

      Modern specialists know about 100 types of operations that are performed to eliminate bunions on the feet. However, the following are often practiced:

    • correction of the transverse arch of the foot;
    • exostectomy;
    • resection arthroplasty;
    • arthrodesis;
    • laser removal of bunions;
    • osteotomy;
    • endoprosthetics.
    • The most common treatment method is correction of the transverse arch of the foot. Experts believe that this hallux valgus operation is the most effective and gentle of all existing types of surgical intervention. During the correction, the doctor changes the angle between the bones of the foot.

      Exostectomy is very often performed. This term refers to the excision of part of the head of the metatarsal bone of the big toe, that is, the removal of that bone that spoils the appearance of the foot. Soft tissues that are located around the joint are also removed.

      An operation called resection arthroplasty allows you to remove a bone in your leg. During surgery, part of the joint from the metatarsal side is removed. Specialists model new articular surfaces and restore the biomechanics of the joint.

      Sometimes doctors perform arthrodesis. This surgical procedure fixes the joint of the big toe and ensures its immobility. During the operation, the cartilaginous surfaces are removed. After this, the bones are fixed. The articular surfaces must be in close contact with each other until fusion occurs.

      Laser removal of bunions is very effective. This procedure is quite new and not very well known. When using a laser, the bones of the phalanges of the fingers are polished. The operation can be performed on both legs at once. The duration of laser treatment for bunions is no more than 1 hour.

      To remove bunions, doctors may use an osteotomy. Its essence is to eliminate deformation by artificially breaking the bone. To relieve patients of bunions, doctors remove part of the phalangeal or metatarsal bone of the big toe.

      And finally, another treatment method often used by doctors is endoprosthetics. During surgery for hallux valgus, the affected joint is completely removed. A replacement implant is installed in its place.

      Rehabilitation after surgery

      After pit removal, you should not get up and walk immediately. On the second day after surgery, doctors allow patients to only move their fingers. After about 7–10 days you can start walking. However, you should not step on the operated area. Otherwise, the healing of bones and soft tissues will be delayed. It is allowed to put weight on the foot only 1 month after treatment, and you can start playing sports and wearing high-heeled shoes after six months.

      Recovery after surgery for hallux valgus deformity is a very important undertaking. To ensure that this period proceeds safely, it is recommended to adhere to the following simple tips:

      1. Wear soft shoes. Models' noses should be wide. It is recommended to give preference to shoes that have a hard and high back and tight arch support.
      2. Use orthopedic insoles. They can be made to order. Thanks to orthopedic insoles, rehabilitation after surgery for hallux valgus deformity proceeds favorably: blood circulation in the foot improves, the load on the joints decreases, and the feeling of fatigue in the legs decreases. In some cases, placing insoles in shoes is very difficult. Then you should use half-insoles - shortened versions of regular ones.
      3. Use crutches. They will provide reliable support when walking and will greatly facilitate movement. In this case, there will be no load on the sore leg.

      If your situation is not yet so advanced, we recommend a modern solution to the problem - the Valgus Pro retainer.

      Categories : Legs

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