Surgical treatment of hallux rigidity

If the mobility in the main joint of the big toe is limited and painful, then this causes a severe impairment in walking. Depending on the cause of painful stiffness during surgery, Brandes and Keller form a mobile joint, or the painful joint becomes motionless. Arthrodesis is also suitable for reducing complaints that arise after surgery for Mauo. The painful joint is operated from a medial-longitudinal incision. After resection of the cartilaginous surfaces, the thumb is brought into a state of extension by 20-25°. Two bone surfaces formed in the form of a roof and attached to each other are well fixed (rice. 8-192). After surgery, external fixation is rarely required. After the wound has healed, the patient can get up and, 3 weeks after the intervention, can begin to walk in shoes with hard soles.

Surgical treatment of concave fifth toe

If the 5th toe turns on the back side, almost lies on the 4th toe and turns steeply upward, then it causes significant complaints. The incorrect position of the finger is corrected by the operation. At the dorso-lateral edge of the V finger, a skin incision is made in the laterally stretched extensor tendon, which at the level of the proximal joint folds into a transverse fold. The extensor tendon is cut in a Z-shape, then dorsally, by capsulotomy, the proximal joint is relaxed. If necessary, the base of the main phalanx is also resected for this purpose. If the finger can then be brought to its normal position, then a diamond-shaped flap is cut out from the plantar fold of the skin located under the finger, and the skin of the fingertip is sutured to the skin of the sole. Thanks to this skin grafting, the plantar fold under the V toe disappears, resulting in an improved position of the toe. AT

Rice. 8-193. Operation on the fifth toe, backward inward, a) Skin incision on the back of the foot b) extension of the extensor tendon, in) plantar skin excision, G) stitching the skin of the fingertip to the plantar skin

rape on the back of the foot connect the ends displaced in relation to each other extensor tendon knotted seam. After the end of the wound healing, the patient can walk and wear normal shoes a few weeks after the operation. The principle of operation is shown in rice.8-193.

Hammertoe surgery by Holunann

One of pathological conditions toes is the so-called. claw-shaped or hammer-like

Rice. 8-194. Operation by Hohmann with hammer toe. a) skin incision, b) and in) resection of the head of the proximal phalanx

Rice. 8-195. Elongation of the flexor tendon of the big toe with a mallet thumb, a) Pathological position of the finger, b) skin incision, in) flexor tendon lengthening

figurative change of them and painful callus. The mallet finger that causes complaints is being operated on. A longitudinal incision is made above the proximal interphalangeal joint of the finger. After longitudinal splitting of the extensor tendon, the head of the proximal phalanx

rises from the joint and with the help of scissors Liston separated and removed (rice. 8-194). This is followed by suturing of the capsule, extensor tendon and skin. After the wound has healed, the operated finger is kept for several weeks in a redressing bandage, the thickening of the skin disappears on its own. If the proximal joint at the proximal joint cannot be brought out of extension, then the incision is lengthened in the proximal direction, and joint capsule is cut on the dorsal surface of the proximal joint. In exceptional cases, you can remove the entire main phalanx.

Hammer toe is a rare disease, which is a flexion contracture in the terminal joint. To eliminate the deformity, the flexor tendon is lengthened in a Z-shape. This operation can restore the function of the thumb. The tendon lengthens at the level of the main phalanx. The skin incision is made at the medial edge of the main phalanx and continues in the plantar fold, t. gets an L-shape (rice. 8-195).

Rigidity of the big toe (Hallux valgus) is a term for a disorder associated with the joint located at the base of the big toe, one of the forms of degenerative arthrosis. It leads to painful immobility of the big toe. An x-ray can be used to diagnose arthrosis of the big toe. In any case, in order to avoid the development of the disease, it is necessary to start therapy as early as possible.

Don't hesitate anymore! Professor Lille will help you find the cause of your suffering and will try to provide you with a speedy recovery.

The reasons

Rigidity of the big toe is a disease of the joint of the big toe, which can have many causes. Uncomfortable shoes, injuries, improper distribution of the load on the foot and overexertion are just some of them. Hereditary factors can also play a big role. Learn more about typical symptoms stiffness of the big toe.

Symptoms

Typical complaints in arthrosis of the big toe:

• restriction of freedom of movement when walking
• pain in the thumb joint
• visible swelling and redness of the affected area
• problems in choosing the right shoe shape
• increased pain in cold weather

Treatment

Depending on the stage of the disease, the desired result is different kinds therapy. At the initial stage of the disease, pain can be alleviated with the help of special insoles and orthopedic shoes. In addition to this, it is advised to undergo a course of physiotherapy. Progressive thumb stiffness is treated with medications and injections that suppress inflammation. During surgery, the bone can be removed or the joint can be replaced with a prosthesis. In any case, in the end, the patient will get rid of pain and will be able to move freely.

Make an appointment with Prof. Lille in Munich. A reputed orthopedist will take all necessary steps to prevent further development of Hallux rigidus.

The muscles of the legs are a painful condition, which is based on increased muscle tone in the presence of constant resistance at the time of performing passive movements. Also, the impossibility of complete muscle relaxation can be considered the main symptom. At the same time, such a condition is not a separate disease, but acts as a symptom of certain pathologies that most often relate to activity. nervous system.

In this case, the diagnostics and proper treatment diseases that caused this pathology.

The main manifestations of rigidity of the muscles of the legs include increasing muscle tension over time and the presence of muscle spasms. It all starts with the muscles of the body, and after a while the disease begins to affect the muscles of the legs or arms. The pathology, as mentioned above, is based on various diseases of the central nervous system, which are based on increased excitability of the alpha motor neurons of the anterior horns. spinal cord. What exactly caused such a pathology has not yet been clarified.

Increased tone can be spastic and rigid. Spastic spreads unevenly and selectively. Rigid, which is also called plastic, spasms all the muscles at once. As a result of this, all sorts of difficulties can arise - in this case they will be associated with walking. This condition can be caused by:

1. Stroke.
2. Brain injury.
3. Sclerosis.
4. Disorder of conduction of nerve impulses.
5. Hypoxia.
6. Encephalitis.
7. Meningitis.
8. Phenylketonuria.

Main features

Determining the rigidity of the muscles of the legs is not so difficult. This disease has clearly defined symptoms that can be determined not only by the doctor, but even by the patient himself. In the presence of at least one of them, expert advice is urgently required.

What should you pay attention to first of all:

1. Muscular tension.
2. Inactivity in the legs.
3. Feeling of discomfort while moving.
4. Stiffness.
5. Spasms.
6. Increased tendon reflexes.
7. Slow relaxation of spasmodic muscles.

Among other symptoms, sleep disturbances, inconstancy of the emotional state, loss of appetite are characteristic. Often people with rigidity move exclusively on their toes, not only in childhood, but also as adults.

In the most advanced cases, the affected muscle becomes so dense that it is almost impossible to feel it, and any touch, even the lightest, for example, massage, can cause severe pain.

An accurate diagnosis may require a visit to the doctor and some diagnostic tests and investigations, such as a blood test, an MRI or an EMG. A specialist consultation may be needed after the initial diagnosis has been made.

Complex therapy

Treatment should take place in two stages. In the first case, the underlying disease is treated, against which stiffness appeared. At the second stage, the muscle spasm itself is treated. But to overcome the disease finally helps only complex therapy, which includes not only the use of drugs, but also massage, physiotherapy exercises, psychotherapy.

Medicines are primarily needed to reduce pain and to normalize the functioning of the nervous system. They should be selected strictly individually, and preferably in a hospital setting. The main drugs can be considered muscle relaxants and neuroleptics. Moreover, the doctor can prescribe only one drug, or a combination of two or three at the same time.

Correctly selected physical exercises allow for autonomy of movement. Moreover, the exercise therapy complex should be aimed not only at relaxation, but also at tension. This should be done from the very first day of the disease. And gymnastics can be supplemented with massage, and you can do it both independently and with a specialist. It is desirable to massage different muscle groups.

Surgery is the last resort when drug treatment and other methods did not give any effect. For many patients, doctors recommend that they undergo a course of rehabilitation with a psychotherapist, and also be sure to undergo a course of treatment in a neurological sanatorium. Sometimes this allows you to positive result much faster than with medication.