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Surgery to remove bunions in Moscow

15 Jun 18

Every woman and girl dreams of looking luxurious and fashionable, which is impossible without sophisticated high-heeled shoes. It makes your gait beautiful and elegant, adds a few centimeters to your height and lengthens your legs, but it can be very harmful to your health.

One of the consequences of wearing high heels that affects most women around the world is bunion. Due to constant loads and a narrow toe, the big toe becomes deformed, an unsightly tubercle appears, which grows over time. This condition causes pain and damage to the body, changes the gait and does not allow you to wear your favorite shoes, so at the first symptoms it is necessary to begin treatment as soon as possible.

Foot deformity, which results in discomfort when walking and an ugly bump on the big toe, occurs most often in women. This is due to the peculiarity of the structure of the ligamentous apparatus of the fair sex, and to wearing high-heeled shoes.

Unlike men, the female body is not designed for heavy physical activity, the ligaments are more elastic, and the joints are more easily deformed, so women are prone to such diseases. When wearing shoes with heels, the center of gravity shifts, the foot is always in the wrong position, it gradually becomes deformed, flat feet may develop, and then a bone appears on the big toe.

The disease can affect even those people who rarely walk in heels or do not wear such shoes at all, and even small children, in this case the following negative factors are provocateurs:

  • Sedentary lifestyle;
  • Metabolic disorders;
  • Hereditary predisposition;
  • Hormonal changes, especially in teenagers;
  • Inflammatory joint diseases;
  • Wearing shoes with narrow toes, even without heels.
  • It is important to note that a lump on the thumb can occur with diseases such as arthritis, arthrosis, gout, in this case the treatment takes a completely different turn, since inflammatory damage to the joints occurs. These diseases can spread to other joints and surrounding tissues, causing impaired motor activity and severe pain, so they must be treated.

    If a man has a bone on his leg, then it is quite possible that this is the first manifestation of arthrosis. Over time, the foot may swell and become very painful, which is not typical for hallux valgus. Only a rheumatologist can confirm or exclude the diagnosis based on radiography; to avoid complications, there is no need to self-medicate.

    Hallux valgus is divided into 4 stages:

  • At the first stage of the disease, the deformation of the finger is not noticeable, but with prolonged walking, especially in heels, unpleasant sensations and aching pain appear. Most often, these symptoms occur when a woman takes off her shoes and stands on a flat surface, but if she returns to her previous position, the pain subsides.
  • At the second stage, pain during prolonged walking becomes more pronounced and bothers you for a long time, the lump becomes larger, it can be seen with the naked eye and palpated.
  • At the third stage of the disease, the bone protrudes greatly, which makes it difficult to wear the same shoes. When pressed, severe pain appears, which is felt if you wear narrow shoes. The disease can be complicated by an inflammatory process in the soft tissues.
  • At the fourth stage, the foot is severely deformed, the bone protrudes. The pain is constant, and the joint regularly becomes inflamed. Due to unpleasant symptoms, the gait changes, the patient begins to limp and take care of the sore leg, the disease spreads to other fingers.
  • Surgery on the bunion of the big toe is considered the most effective treatment method, and allows you to completely get rid of the growth and accompanying symptoms. In the last stages of the disease, conservative methods usually do not help; they only relieve pain and inflammation, but the lump on the big toe remains.

    Indications and contraindications

    Only a doctor can prescribe surgery to remove a bunion on the basis of an x-ray and in the absence of contraindications.

    Indications for surgery:

  • Stage 4 of the disease, when the finger deviates by 50 degrees or more;
  • if, when palpating the joint, a tightness is felt and motor activity is impaired;
  • if the pain is constant;
  • if the joint is inflamed.
  • age over 70 years (due to health reasons);
  • diabetes;
  • diseases of the heart and blood vessels;
  • period of pregnancy and lactation;
  • impaired blood flow to the foot;
  • exacerbation of chronic diseases;
  • malignant tumors;
  • HIV infection.
  • Preparing for surgery is a very important period that must be taken responsibly. First of all, the doctor refers the patient to the necessary studies and prescribes a series of tests:

    Based on the test results, the doctor decides on the possibility of surgery. If it is prescribed, then before it is carried out, the specialist prescribes a number of procedures and medications that must be taken. These can be physiotherapeutic procedures, massage, which can reduce pain and relieve inflammation.

    How is the operation performed?

    Surgery on the bunions can be minimally invasive, that is, performed through small punctures, or classical, when an incision is made with a scalpel and the necessary manipulations are performed. Nowadays, there are more than 180 methods of surgical intervention; the doctor chooses the one necessary in a particular case.

    The specialist’s decision depends on the patient’s age and the condition of the foot. The joint can be removed completely and replaced with a prosthesis, or the ossified growth can be separated and removed. For minor bone deformities in young people, the doctor can perform muscle truncation, which will help remove the visible defect.

    Typically, a classic operation to remove a bunion on the big toe takes place in several stages:

  • First, the patient is given anesthesia, most often an epidural.
  • Before the operation, the doctor sanitizes the skin, wipes it with alcohol and iodine.
  • Then an incision is made, and the doctor performs the planned manipulations.
  • The next step is to apply stitches and a tight bandage.
  • Typically, the patient is left in the hospital for no more than two days, after which he is allowed to go home. Sutures are removed 10-12 days after surgery if healing has gone well. If titanium screws have been installed, they are left in place for at least 3 months, after which they can be removed in the clinic, but they may not be removed at all; they usually do not create any unpleasant sensations.

    On average, the rehabilitation period is at least a month, but this period may increase depending on the severity of the patient’s condition and the type of surgical intervention used in a particular case. With a minimally invasive method, less tissue is damaged, so the leg heals much faster.

    In the first week after surgery, the patient is prescribed antibiotics and non-steroidal anti-inflammatory drugs. These medications help relieve pain and inflammation in tissues, and reduce the risk of developing infectious complications. In addition, regular dressings are prescribed, which must be done by a specialist, since they are quite tight.

    During the rehabilitation period, it is forbidden to shower and wet the operated leg, load, drive a car and wear tight shoes. After removing the bandage and stitches, swelling persists for a long time, so it is recommended to wear orthopedic shoes or use special insoles.

    Wearing shoes with heels is permitted no earlier than six months after surgery. The same restriction applies to physical activity; the patient is not recommended to carry heavy objects and spend a lot of time on their feet.

    In rare cases, the following complications may occur:

  • Bone necrosis, this complication provokes a malnutrition of the bone;
  • Relapse of the disease;
  • Impaired finger mobility, this problem can be cured with exercise therapy;
  • Inflammation of the wound, this leads to poor healing of the suture if it becomes infected;
  • Severe swelling, this complication goes away within 4 months;
  • Loss of sensitivity in the affected area; this symptom disappears within a year after surgery.
  • If the patient has any complaints or doubts during the postoperative period, they must tell the doctor about them. Especially if there is a sharp pain in the area of ​​the suture, it becomes wet, begins to bleed or festers, in this case there is a risk of infection and urgent treatment is necessary.

    Surgery to remove a bunion can be done free of charge under your compulsory health insurance policy. To do this, you need to receive a referral for the procedure from an orthopedic doctor, then the patient will be put on a waiting list. The waiting period can range from several weeks to several months, it all depends on the equipment of the clinic.

    If you don’t want to wait, you can sign up for surgery for a fee in specialized clinics. The cost of such a procedure may vary depending on the status of the clinic, the experience of the doctor and the region in which the operation will take place. So in Moscow prices are usually much higher than in other Russian cities. The national average cost of the procedure ranges from 10,000 to 30,000 rubles.

    Treatment and prevention

    Conservative treatment for hallux valgus is considered ineffective, especially in the last stages of the disease. At the first and second stages of the disease, doctors prescribe wearing special orthopedic devices, as well as attending physical therapy, massage and exercise therapy, and prescribe various medications to relieve symptoms. Such treatment may be indicated as preparation for surgery to reduce inflammation in the tissues.

    Traditional medicine

    Orthopedic methods are used for both treatment and prevention of bunions. These include special shoes and orthopedic insoles, orthopedic splints, finger guards and expanders. These devices help relieve pain and stop further deformation of the foot. The doctor selects the method of treatment individually, depending on the stage of the disease.

    Drugs are also prescribed, these can be non-steroidal anti-inflammatory drugs, painkillers and even steroid drugs during periods of severe pain. The latter are used as injections into a sore joint, this allows you to quickly relieve inflammation and relieve pain.

    For a bunion on the big toe, the following physiotherapy procedures are prescribed:

    Physiotherapy exercises are also prescribed for the treatment and prevention of bunions. Thanks to regular exercise, you can improve blood circulation, strengthen muscles, thus reducing pain. Such exercises are effective at all stages of the disease, but they will not help completely remove the bone.

    When treating hallux valgus, it is possible to use folk remedies, but only in complex therapy. Baths and lotions will help improve blood circulation in tissues, relieve swelling, inflammation and pain. Often, thanks to such procedures, it is possible to relieve pain, then the patient can refuse to take painkillers or reduce their dosage.

  • Chamomile. Chamomile lotions and baths are an excellent anti-inflammatory remedy. To prepare it, you need to brew 3 tablespoons of dried flowers with 300 ml of boiling water, let the broth brew for 60-80 minutes, then strain. The resulting liquid can be added to a bath of warm water and place your feet there for 15 minutes. For lotions, you need to soak a cotton pad in the broth and apply it to the sore spot, wrap it with cling film on top and leave it overnight.
  • Paraffin baths and compresses are very effective for joint diseases. It is necessary to melt the paraffin, the temperature should not exceed 50 degrees. When the liquid is ready, you need to add a few tablespoons of mineral oil and a few drops of essential oils for scent (optional). Dip the sore finger together with the lump into the resulting mixture at least 5 times. To do this, you need to lower your finger, pull it out and wait until the paraffin dries, repeat the procedure. After which you need to immediately wrap your foot with cling film and put on a woolen sock, and keep this compress for at least half an hour.
  • It is important to note that before using any product, you should always consult with your doctor. A bunion is a serious disease that requires timely and adequate treatment; in this case, you should not self-medicate.

    Surgery to remove bones from the thumb is the best way to get rid of the problem.

    I want to tell you about the operation to remove bunions on my big toes, which my grandmother underwent not so long ago.

    Let me start by saying that she had problems with her legs in this area for a long time. At first it manifested itself slowly, but then it began to torment more and more. I don’t know why exactly it started for her, but she almost always wore orthopedic shoes.

    At first she somehow did not struggle with this illness, and it did not particularly bother her. But when the bumps already became noticeable, special overlays came to the rescue, which are currently being actively advertised. So, she used them regularly, but the situation did not improve one bit, and the disease progressed and the bumps became visible even through her shoes, they were sticking out so much. And it was already becoming painful for her to walk, and she began to constantly complain.

    She has a friend in Moscow and after calling her, her grandmother complained about her problem. It turns out that a friend also suffered from lumps and underwent surgery to remove them and now does not know grief. She said that they have a clinic in Moscow on Fadeeva Street, 2, where they quickly perform surgery. It is performed by orthopedic traumatologist Sergei Yuryevich Dedov. And she convinced her grandmother to go visit her and have the operation.

    Of course, we doubted it a little, but we thought about it and decided what needed to be done, since life after the operation would be of a higher quality, and if my friend had already undergone it, then we could trust her. In addition, surgery and rehabilitation are inexpensive. In addition, my friend already knew everything and took full control of the entire process.

    My grandmother had tests done at their clinic and they made sure to do an x-ray. It turned out that she had a 3rd degree deformity. After the operation under epidural anesthesia, which my grandmother tolerated well, she called back. She said that everything went fine and that she felt good. She was assigned to a ward for several days. There was almost no pain in my legs. Then she moved to a friend’s place and there she already tried to start walking. I went for dressings every week 2 times. After 3-4 weeks, she was almost completely recovered from the operation. I arrived home after 1.5 months with brand new legs and a great mood.

    I can say myself that it looks like heaven and earth. The legs are straight and there are no bumps. And there are no complaints from grandma; we can say that she began to run and became more active, despite her age. I changed all the old shoes that were deformed on the sides and bought normal ones, but without heels.

    So I think the surgery is worth it.

    Unfortunately, my dear aunt also developed problems in this area of ​​her legs. But now we don’t worry, because there is a competent specialist - Sergey Yuryevich Dedov. Still, the operation gives an amazing and most effective effect; various devices were not even close.

    Should bunions be removed with laser?

    Removing bunions using laser

    In many plastic surgery clinics, the laser treatment method is used quite widely, and there are already positive results. And despite this, laser removal of bunions is a new phenomenon and therefore not known to many people.

    What is a bunion? Of course, the human foot consists of several dozen (!) small bones. But everyone knows perfectly well what is meant - the growth of a lump around the big toe, its incorrect position. Usually the finger “looks” with its tip inward of the foot, sometimes “running into” the adjacent middle finger.

    Symptoms of bunion (foot hallux valgus)

    In foreign literature the bone is called bunion

    One can only guess how much suffering this disease causes to women (and these are most often women). Or ask your mother or grandmother about the symptoms. They will tell you that it is impossible to wear shoes with high heels - this makes the bunions hurt very much.

    They will tell you that the shoes last only one or two seasons, again because of the damned bump. Yes, in the end, it is simply unsightly, the foot takes on an ugly shape, and this is often the most upsetting thing.

    Hallux valgus (the scientific name for a lump) is not very noticeable at first. The toe deviates outward so gradually that the defect begins to be noticed when the shoes become too small or when pain appears in the foot.

    As a result, we have the following symptoms:

  • foot deformity;
  • pain of varying strength (an inflammatory disease of the joint - arthritis) may occur;
  • restriction of movement in the joint;
  • pain when moving the joint;
  • the bone hurts when wearing regular shoes, because the shoes become small, press and rub the skin;
  • The second finger is often deformed - it becomes like a hammer, hence the name - hammer-shaped deformity;
  • from the pressure of shoes, calluses and abrasions appear, and the skin of not only the big toe, but also the second, little toe and even between the toes is affected;
  • in some cases, an ingrown nail forms (from excess pressure).
  • Laser correction of foot bumps

    Today we will talk specifically about laser correction of this defect.

    So, removing bunions with a laser is still an operation; it is performed under local anesthesia. You can operate on two limbs at once, and this is very convenient, you will agree... But, unlike a conventional operation, the protruding parts of the bone are not cut off, but only polished using a laser device.

    Benefits of laser treatment

    In this case, the protruding part is still noticeably reduced. And the main advantage of such an operation is that after it the lower limb is not encased in plaster. You can walk within a few hours (albeit with some restrictions).

    And after 7-10 days you will already be able to move freely “on your own two feet” without any help. Not to mention the fact that the patient is discharged from the hospital one day after the operation.

    Treatment of bunions without surgery

    If you have not yet decided to take drastic measures such as surgery, be sure to consult with an orthopedist about what insoles or spacers you need to choose to make walking comfortable.

    The main advice is don’t leave your bumps alone! They will grow more and more if you do not take at least the simplest methods to correct foot deformities.

    Now watch the video and useful tips about bunions:

    Removing bumps on feet

    Surgical treatment of hallux valgus, correction of bunions and bunions on the feet

    My bumps began to grow so quickly that I didn’t even notice how difficult it became for me to choose shoes for myself, I had to buy orthopedic ones in a special store, it was no longer possible to wear regular ones, I probably decided to have surgery only because my mother had the same problem, and she had the operation of the year.

    She had surgery on 09/16/14 at the R.R. Vreden Russian Research Institute of Traumatology and Orthopedics

    I didn’t get ready for long, as I started to worry about allergies and pain! Plus, transverse flat feet resulted in swelling of the ankles (I chose the surgeon carefully - my miracle doctor was the Head of the department, Vladimir Gennadievich Emelyanov

    The lump on my right leg was not very big, but the pain was noticeable. The pain was especially aggravated by changes in weather. Special baths and all sorts of lotions with ointments did not help get rid of the problem. To my shame, I admit that I put off going to the doctor to the extreme. I was glad that this operation (to remove cones on...

    I removed bumps on my legs, despite all the difficulties – I’m happy with the result

    I had surgery two months ago. On one leg, after the lump was removed, swelling persisted for a long time, but on the second leg everything was fine. I didn’t need any plaster, I only wore orthopedic shoes. She left the hospital on crutches, and within a week she was walking perfectly on her own. The most difficult thing for me was enduring anesthesia.

    Removed a bump on my foot the right way

    It was painful for me to walk because of a lump in the area of ​​the big toe on my right foot. But I stubbornly believed that special lotions and baths would help me get rid of the problem. The more I delayed going to the orthopedic doctor, the more my leg hurt. It got to the point where it was difficult for me to press the pedal in the car.

    The only thing that helped me was surgery

    I am 48 years old and have suffered from bunions on my legs most of my life. In my youth I started wearing high-heeled shoes, I didn’t think about convenience and comfort, the main thing was that it was beautiful and fashionable. Even then, pain in the foot began to bother me, but there was no obvious deformation of the bones yet. She appeared after.

    Removal of “bones” on the legs

    It all started when I bought ballet shoes in a store. It would seem, what shoes could be more comfortable? But the consequences that resulted from wearing them became the most deplorable for me. At first they squeezed a little and rubbed on the bones. "It's OK!" — I thought, this is not the first pair of shoes I have to break in. Then it appeared on my feet.

    Definitely worth the surgery

    By the age of 47, I had bumps on both feet near the big toes (I have had a love for high heels since my youth). The pain began a long time ago, even when the bumps were not yet protruding much, but only intensified with age, especially if I had to spend a lot of time on my feet, regardless of shoes. When the bumps became too much.

    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:

      1. An incision is made on the inside of the big toe phalanx.
      2. A capsulotomy is performed (dissection of the capsule of the first metatarsophalangeal joint).
      3. Excision of the bone outgrowth (bump removal) is performed.
      4. The first bone of the metatarsus is sawed (an osteotomy is performed).
      5. The surgeon moves fragments of the metatarsal bone, changing the axis of the deformed area.
      6. The bone is fixed with titanium screws or staples.
      7. The capsule and incision are sutured.
      8. A sterile bandage is applied to the access site.
      9. 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.

    Surgery to remove a bunion on the big toe

    Hallux valgus is a pathological curvature of the metatarsophalangeal joint, which is accompanied by the formation of a protruding bone at the base of the big toe. These alarming signs of the disease are not only unaesthetic, but also fraught with serious consequences - flat feet, gout, joint destruction. And if measures are not taken in time, surgical intervention will be required - surgery on the bones in the legs.

    When is surgery needed?

    In the initial stages, hallux valgus deformity is manifested only by the appearance of corns and calluses at the site of the lesion. The symptoms do not yet cause severe inconvenience - you can still wear any shoes, the crooked joint does not hurt. If it is impossible to see a doctor now, the situation can be dealt with using gentle methods - physiotherapy, wearing bandages, massages, exercises. We especially recommend the Hallyufix orthopedic valgus splint.

    Patients with hallux valgus deformity at stages 1 and 2 rarely seek help from a doctor - first, “grandmother’s” recipes are used. But folk remedies are powerless in most cases - the bone continues to “grow”, causing more and more inconvenience to the person. And in rare cases, when the disease is advanced and the patient’s condition worsens, doctors prescribe surgery.

    Surgery to remove bunions is performed when:

  • severe pain prevents you from walking normally;
  • not only the joint of the big toe is bent, but also the rest of the bones on the foot;
  • the first signs of flat feet were diagnosed;
  • the affected area swells and hurts even at rest;
  • noticeable redness of the skin;
  • Bleeding calluses appear in the area of ​​the protruding bone.
  • Fear of hospitals and doctors should not become an obstacle for the patient! If you notice any alarming symptoms of hallux valgus, make an appointment with an orthopedist. Study reviews about the operation - surgeons have already helped thousands of patients get rid of pathology.

    Find out where and how bunion surgery is performed, since there are contraindications for surgery. The doctor, taking into account the general health of the patient and the degree of damage to the joints, will select the correct technique to eliminate any negative consequences.

    Contraindications include:

  • poor blood clotting,
  • diabetes,
  • hypertension,
  • chronic pathologies of the musculoskeletal system.
  • If the lump on the leg is inflamed, the patient is first prescribed therapy to relieve the infection.

    Surgical techniques

    Previously, surgery involved excision of the curved bone and fixation of the joints with metal structures. The technique is very traumatic - there were often serious complications, and the patient required long-term rehabilitation. Today, surgery to remove a bunion on the big toe is performed using modern medical equipment; the latest technologies have been introduced to help quickly get the patient back on his feet.

    In medical practice, 90% of operated patients then experience an excellent result - the bunion on the big toe no longer causes inconvenience. Positive reviews from patients prove that only surgery helps to forget about the problem forever.

    Surgery on a hallux valgus is often performed using one of the following methods:

  • Exostectomy. Excision of part of the metatarsal head on the big toe. The soft tissue surrounding the bone must also be removed.
  • Correction of the transverse arch of the foot. The technique is used more often than others - a practice that has been developed over the years. It is believed that in this case the patient’s recovery is quick and painless. During the operation, the surgeon changes the angle between the bones so that the joints “fall” into place.
  • Resection arthroplasty. This operation to remove cones on the legs involves truncation of part of the joint from the metatarsal bone and complete restoration of its biomechanics.
  • Osteotomies. This is an artificial fracture of the bone in the affected area of ​​the joint and removal of part of it. After the operation, the patient will undergo a long rehabilitation period - physical therapy and wearing orthopedic shoes.
  • Endoprosthetics. The crooked joint is removed and replaced with an implant. After the recovery period, the patient can lead a full life - a high-quality prosthesis eventually ceases to cause any inconvenience. This technique is offered in private clinics, and the price of surgery on the big toe bone can be quite high.
  • Arthrodesis. During the operation, the cartilaginous surfaces are excised, and the joint is securely fixed. Complete immobility of the articular surfaces is necessary for their fusion. The postoperative period is difficult, since the patient is shown complete rest and the absence of even the slightest stress.
  • Surgery on bunions on the legs does not have an immediate effect - you must undergo a course of rehabilitation. High loads are placed on the leg joints, and the patient is allowed to get out of bed only after 7-10 days. You can fully put weight on your foot after a month, otherwise the operated joints and tissues will not heal. Depending on how the surgery for hallux valgus is performed, playing sports and wearing high-heeled shoes is allowed only 3-6 months after surgery.

    For rehabilitation to go smoothly, the patient must follow the following rules:

  • Special orthopedic shoes after bunion removal surgery will help to evenly distribute the load on the foot, relieve pain when walking and improve blood circulation. You can order orthopedic insoles - they also give a good effect. Rehabilitation shoes are expensive, but they are the only way to achieve a speedy recovery.
  • No heels! The shoe material should be soft, the instep should be dense.
  • See your doctor regularly for check-ups. If the bones heal incorrectly, measures should be taken - another operation is prescribed.
  • Restorative massages and a course of physiotherapy are required.
  • Laser treatment: fast and effective

    Today it is possible to minimize the recovery time after surgery to 2-3 weeks. Many clinics offer patients laser removal of bunions. A very effective technique that does not cause any discomfort to the patient.

    The cost of surgery to remove a bunion on the big toe using laser technology is quite high - at least 20,000 rubles. This is what “scares off” many patients. But when compared with other technologies, laser is much safer. The cost of the operation is quite justified, given the latest equipment and the highly qualified specialists who must perform it.

    The operation itself lasts about an hour. The patient is given only local anesthesia, which significantly reduces the risks of complications and makes it possible to treat hallux valgus even in elderly people. During the operation, the protruding bone seems to be polished with a laser beam. The patient’s leg is not then put into plaster! Loads on the foot are allowed 2 months after the procedure.

    The cost of the operation depends on the stage of the disease. Find out where you can have laser surgery - choose a suitable clinic and make an appointment with a doctor.

    How is surgery to remove a bunion on the big toe performed?

    A common foot disease, popularly referred to as a bump or a protruding bone near the big toe, is characterized by doctors as valgus pathology. This foot deformation causes inconvenience when walking, wearing shoes, causes pain and an unattractive appearance. It is first treated with improvised, folk remedies, then with conservative medicine. However, if the first metatarsal bone extends from the others at an angle of more than 18°, and the big toe, in opposition to it, gives a curvature of more than 35°, then surgery for a bunion on the big toe is required.

    Preparation for operating procedures

    Before removing bunions, the doctor conducts a thorough diagnosis, including x-rays of the foot from different sides. In modern condition analysis, in addition to X-rays, the most complete and accurate information is obtained using magnetic resonance imaging.

    Studies will determine whether the patient has arthrosis or osteoporosis, how enlarged the lump is, or whether the thumb is deformed.

    The doctor also gives directions for the following tests:

  • Blood sugar, coagulation - hemostasiogram, biochemical and clinical tests;
  • General urine analysis;
  • Determination of HIV and hepatitis;
  • Electrocardiogram;
  • Fluorography.
  • Approximate cost of surgery

    After deciding on the need for surgical treatment of the problem, the question arises: how much does surgery to remove a bunion cost?

    There is a quota for performing free operations of this kind with a compulsory health insurance policy, although such free operations are quite rare. To use this option, you need to get a referral from an orthopedist and wait your turn. This may take several months.

    The cost of a paid intervention depends on the type of operation, the equipment of the hospital, the availability and qualifications of doctors, the territorial location of the hospital, the status of a municipal or private clinic, etc. In Moscow, the cost of operations with different methods of execution will be from thirty to sixty thousand rubles, in regional hospitals - the price is lower: minimum from ten thousand. The cost usually includes orthopedic consultation, anesthesia, and dressings. Due to the progressive nature of the operation with a small incision, its price will be higher than the usual one.

    If laser intervention is required, this will add about ten thousand rubles to the cost. Sometimes during the operation and immediately after it, inpatient observation is necessary. In this case, for example, a four-day stay in the capital along with surgery on one leg will cost one hundred thousand rubles. In each individual case, it is recommended to clarify the cost.

    Symptoms of the disease leading to foot surgery

    Surgery to remove a bunion on the big toe is desirable in the last stage of curvature of the big toe and the following symptoms:

  • High joint density;
  • Severe flat feet;
  • Inflammatory processes in the joints of the foot lead to redness of the skin;
  • Painful sensations not only when walking, but also in a calm state;
  • The big toe is bent excessively, its deviation is above fifty degrees, the rest of the bones of the foot are also curved;
  • Calloused bleeding covering the area where the lump bulges.
  • If a patient wants to correct the aesthetic discomfort of a foot deformity, and conventional methods do not lead to results, then a surgical decision can be made earlier, before all of the listed symptoms appear. It is taken into account that with smaller changes, only the lump – exostosis or part of the muscle – needs to be removed. This minimizes postoperative complications.

    Expected postoperative result of lump resection

    The purpose of the surgeon’s removal of a leg bone during surgery is:

  • Relief of joint pain syndrome. Already on the second day, a decrease in pain becomes noticeable.
  • Rehabilitation of thumb movement activity. This occurs after the final recovery of the foot.
  • Restoring aesthetic appeal. Along with the elimination of the defect, psychological discomfort goes away, as the foot begins to look beautiful.
  • Contraindications for surgery

    Despite the strong desire to get rid of the problem, it is worth considering that surgical correction has contraindications:

  • Thrombosis with inflammation of the vein walls and blood clotting disorders.
  • Obesity, diabetes.
  • Cardiovascular failure.
  • Disorders of blood circulation and nerve supply to the tissues of the foot.
  • Pathologies of the musculoskeletal system.
  • Technological features of different surgical techniques

    Previously, the usual intervention of surgeons was to remove the lump and secure the joint with metal pins and staples. This traumatic invasion had many complications and a long recovery for the patient in the postoperative period. The desire to put beautiful and fashionable shoes on my feet would come true after at least a year.

    The latest methods for removing bunions using innovative technologies and high-quality equipment make it possible to do this much more effectively in ninety cases out of a hundred:

  • The open method is a cut using a scalpel in the tissue down to the bone and its subsequent removal. The surgeon conducts his actions, having an overview of the area of ​​the operation and the state of its process.
  • Closed - through the skin - allows you to make a minimal incision and perform manipulations through it.
  • Operations with minimal internal damage

    Surgeries with mini-skin incisions, no more than three millimeters, are minimally invasive interventions. Through minimal sections with a microscalpel, the surgeon saws through part of the bone where necessary. This changes the axial orientation of the finger, eliminating unnecessary bending.

    In our country, percutaneous minimally invasive osteotomy has been successfully used in recent decades, the advantages of which have already been assessed:

  • Short rehabilitation period;
  • Small scars are more aesthetically pleasing and less noticeable;
  • Less intense pain, easier to eliminate;
  • Lower risks of complications.
  • The procedure takes place under local or spinal (epidural) anesthesia. The puncture is made with a scalpel with a very narrow blade to create an operating space by cutting through the soft tissue. The doctor drills a hole in the metatarsal bone of the foot using an auger, a device for removing a bunion. The hole is irrigated from time to time with saline solution.

    When the diameter reaches 2 mm, a metal needle is inserted into the hole from one side. Then it is secured with a second knitting needle on the other side and a screw with a diameter of 1 mm. Their interaction causes the bone to lie correctly. The pins will be removed at a later stage, after which an x-ray will be taken and the fixation screw will remain. If necessary, the bones will be shortened. In case of very severe deformation, the hole is adjusted to a maximum of 10 mm. In ordinary cases, stitches are not even required, just an antiseptic bandage for a couple of days.

    Types of surgical treatment for bunions on the big toe

    Currently, there are about 200 types of operations in this area. Of these, the following have become popular and universal:

  • Removal of a protruding bone on the side of the surface of the beginning of the first bone of the metatarsus and phalanx of the big toe - ecstotic resection.
  • Removal of part of the first metatarsal bone - Hochman osteotomy.
  • Shortening of a stretched muscle. It is used for young patients with slight deformity of the foot and the absence of arthrosis symptoms - McBride operation.
  • Osteotomy of part of the first metatarsal bone or digital first phalanx in case of severe pathology in elderly patients - removal according to Wreden-Mayo.
  • A prosthetic procedure, where the prosthesis - an autoimplant - is created from the tissues of the patient. It correctly fixes the bone - this is a reconstruction using the CITO method.
  • Stages of surgery and types of bone removal

    All techniques are characterized by a step-by-step algorithm for how to perform surgery on a bunion:

  • An incision is made inside the surface of the phalanx of the big toe.
  • The surgeon cuts the capsule of the first metatarsophalangeal joint to prepare it for surgical manipulations - this is a capsulotomy.
  • Next comes the removal of the callus, in medicine called an exostosisectomy.
  • Now comes the turn of osteotomy - sawing of the first bone of the metatarsus.
  • After an osteotomy, the trauma surgeon changes the axis of the deformed area of ​​the finger, moving parts of the metatarsal bone.
  • Then fixation is performed with titanium screws or other metal devices - arthrodesis. It is important that the joints are in firm contact with each other for complete fusion.
  • The first metatarsophalangeal capsule of the toe is now sutured.
  • Upon completion, a sterile bandage is applied to the operation site and a fixing bandage is applied to the foot.
  • The duration of the operation is from 30 minutes to 2 hours. It depends on the amount of work and the degree of complexity of the deformation.

    There are different types of osteotomy:

  • Chevron - to eliminate a small defect, correcting deviations between the first and second metatarsal bones. During this operation, the base of the head of the first metatarsal bone is sawed in a V-shape, corrected in the required direction and distance, and the bone fragments are fixed with screws. Unnecessary bone parts and excess joint capsule tissue are removed. Sutures are placed to achieve the anatomical curve of the thumb.
  • In case of slight curvature, Akin intervention – wedge-shaped osteotomy is possible. A bone wedge is removed from the main phalanx of the thumb to allow the bone to heal as needed, and tendon stretching is normalized. This method is not always effective, so surgeons use it in combination with others.
  • With a moderate degree of valgus deformity of the big toe phalanx, Scarf osteotomy is used, which is in many ways similar to the chevron one. It represents a bone cut and adjustment after this position and connection of its parts in the right direction. The dissection is carried out in a Z-shape. The origin of the bone is separated from the base and moved into the optimal position to align the articular surface with the phalanx of the finger. Using screws and then sutures, the bones are fixed and part of the middle tissue is removed. This universal procedure is good because it shifts the bone fragment in different directions (middle, back and down). This significantly reduces the load on the first metatarsophalangeal joint and the part of the foot inside. With this method, you can also lengthen the first metatarsal bone if its size is small or shorten it if it is too long.
  • Characteristics of removal procedures

    Extotic resection can be performed in a hospital, but without further stay there. An intraosseous injection of novocaine will be a local anesthetic. When the operation is performed, the incision is about five centimeters long, the soft tissue is folded back, and the bone is exposed. The lump is knocked down with a chisel and its surface is polished, the tissue base is returned to its place and stitched with surgical thread. A thick cotton wool pad is secured between the big and index toes with special glue, the foot is treated with iodine solution, and a splint is applied.

    For Hochmann osteotomy, the anesthesia is the same as for removal of ecstosis. A surgical incision is made along the phalanx of the big toe and metatarsal bone. In the area of ​​the cone, the mucous bursa formed by friction of the joint and skin is removed. The tendon attached to the phalanx is cut off, and the surgeon knocks out the metatarsal bone with a chisel and removes a wedge-shaped part to align the articular axis. The remains of the bone are then fixed with a metal wire or plate. The lump is completely removed by sawing off. The tendon is made shorter and sutured to create proper tension, bony anchorage, and axial alignment. Sewing up the tissues completes the process, and a cast is placed on the foot for three weeks. Complications in this case are much less common than with resection of ecstosis.

    The McBride operation is performed with local anesthesia.

    The cut occurs from the plantar side to separate the muscle, which is attached to the phalanx of the big toe by its end. It is made shorter by sewing not to the phalanx, but to the metatarsal bone.

    Removal according to Wreden-Mayo is performed under local anesthesia with an arcuate tissue incision. The surgeon then dislocates the bone that needs shortening using a bone scoop. The diseased part of the bone is cut off with a saw, the edges of which are polished. Here a large area is removed. The splint is applied after the tissues are sewn up. The results are usually good, but recovery of the musculoskeletal capabilities of the foot takes a long time.

    Reconstruction using the CITO technique is possible in parallel with osteotomy under local anesthesia. The surgeon cuts the tissue pulp, removes the wedge-shaped section of the metatarsal bone, performing an osteotomy. Where space is available, a graft made from the patient's tendon is placed. Additional fixation is created with knitting needles, which are then removed. To ensure that the bone is held in its anatomical position, the tendon is made shorter and then sutures are placed. The foot is cast and left for a month and a half. This technique is complemented by endoprosthetics with the difference that the diseased joint is completely removed and replaced with an artificial implant.

    The most effective surgical option at the moment is laser removal, which is done under local anesthesia for no more than an hour on both legs at once. This is grinding of a protruding bone with a special apparatus until the surface of the foot is completely leveled. With laser bone extraction, trauma is minimized and healing is rapid. No need for a cast or splint. The patient can quickly return home on the same day, relying, among other things, on his sore leg. The finger then develops after three weeks from the operation, without the suffering inherent in healing with other methods.

    Postoperative recovery period

    How long recovery will take after bunion removal depends on how much tissue and parts of the bunion were removed. If only part of the metatarsal bone is removed, the fixation of the joints will last four weeks, of course, if a non-laser operation was performed. When the largest lesion is removed, the rehabilitation period increases to ten weeks. It is important to limit any stress on the surgically treated foot at this time.

    Only the next day, depending on the surgical method, is sometimes allowed to move the fingers. You will generally be able to walk no earlier than in a week, being careful and avoiding putting pressure on the injured leg. If this is not done, the healing of soft tissues and bones may be delayed. Only after thirty days is it possible, after consultation with a doctor, to walk normally with the support of the foot.

    Features of restoration of musculoskeletal functions of the foot

    After the rehabilitation period, the doctor will establish a special regime for several months while recovery occurs after the removal of the bunion. It affects:

  • Special complex therapy, including antibacterial, anti-inflammatory and analgesic effects.
  • An individually developed physical therapy complex for the toes by a doctor. Its daily implementation is mandatory after the postoperative swelling has subsided (approximately twenty days after the surgical procedure). This is necessary to avoid the formation of scars that prevent the normal flexion and extension of the toes of the damaged foot.
  • Shoes after bunion removal are soft, with a wide toe, a hard and high heel, and a tight instep support. We recommend Baruk shoes, which relieve the load on the forefoot using a special wedge shape. This helps postoperative wounds heal faster and the post-traumatic period is easier to endure. To ensure the necessary hygiene measures, they have special removable insoles. For cold weather, such shoes come complete with a special lining that protects from dust, moisture and cold. Shoes can be washed at sixty degrees.
  • Custom made orthopedic insoles. They will improve blood circulation in the foot, relieve feelings of fatigue and relieve stress on the foot. An option could be semi-insoles as a shortened model of traditional orthopedic insoles.
  • If a moment arises in life when it is unbearable to endure the pain and unsightly appearance of a protruding bunion on the big toe, wide shoes for constant wear are unacceptable and nothing helps, then it is important to consult a doctor in time to find out the operability of the problem. With a wide range of surgical treatment methods available, you can, together with your doctor, choose the best option for a speedy recovery.

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