The deformity of the big toe is observed with Hallux valgus, gout, arthrosis of the I metatarsophalangeal joint, rigid first toe, progressive ossifying dysplasia. In the latter case, it is congenital, in the rest it is caused by a change in the angle between the metatarsal bone and the main phalanx, bone growths, swelling and inflammation. The cause of the pathology is established according to the survey, physical examination, radiography, plantography, laboratory tests. Until the diagnosis is clarified, it is sometimes possible to use analgesics and NSAIDs.
Hallux valgus is the best known and most common cause of deformity of the first toe. Due to weakness of the ligaments of the foot, combined with transverse flat feet. It is more common in middle-aged and older women. The thumb deviates outward, as a result, an angle is formed between it and the I metatarsal bone.
Over time, the deformation often progresses. Violations of the aesthetics of the foot are aggravated by fibrous growths, calluses and concomitant arthrosis. The second finger bends, becomes hammer-shaped, superimposed on the first. After a long stay on the legs and in the acute phase of arthrosis, the deformity is somewhat aggravated due to soft tissue edema.
Osteoarthritis develops after injuries, against the background of other diseases or due to the anatomical features of the foot. Post-traumatic arthrosis can be diagnosed at any age, other types of the disease are more often detected in the second half of life. A noticeable deformation appears with a prolonged course, due to the formation of osteophytes, concomitant fibrous changes in soft tissues.
Occurs against the background of osteoarthritis. It is accompanied by an increasing decrease in mobility in the 1st metatarsophalangeal joint. In the later stages of rocking motion, patients have difficulty walking in any footwear. The cause of the deformity of the thumb is large bone growths and inflammation of the soft tissues.
Big toe deformity
The defeat of the joint of the thumb is characteristic of gout. In the initial stages, the deformation occurs during a gouty attack. Sharp, sharp, unbearable pain suddenly appears in the joint. The affected area swells, the skin over it becomes hot, bright red. After a few days, all manifestations disappear, the shape of the foot is restored.
In the subsequent attacks are periodically repeated. In the interictal period, tophi are detected under the skin at the base of the thumb - painless nodules up to 2 cm in size. Over time, patients may develop secondary deforming arthrosis, the deformity in such cases becomes permanent.
The hallmark of this genetic disease is clinodactyly of the first toes. The fingers are shortened, due to valgus or varus curvature, their axis does not coincide with the axis of the foot. This is a rare type of clinodactyly - usually this congenital anomaly affects the little fingers, not the thumbs. Identification of the sign allows you to suspect fibrodysplasia even before the appearance of other symptoms of the disease.
Temporary deformation occurs with bruises and fractures. Bruises are characterized by moderate edema, quickly subsiding pain, preservation of limb function. Severe swelling, cyanosis, and bruising are typical for finger fractures. With fractures of the nail phalanx, subungual hematomas occur. With damage to the main phalanx due to significant swelling, the thumb resembles a sausage.
With lesions of the metacarpal bone, the zone of maximum swelling and pain is localized in the distal part of the foot, the swelling passes to the finger. All fractures are accompanied by significant dysfunction of the foot. Support on the inside of the foot and rolling become impossible. When the fragments are displaced, the deformation is aggravated by shortening or violation of the axis of the finger.
Diagnostic measures for deformities of the big toes are carried out by orthopedic traumatologists. If there are indications, patients are referred for a consultation with rheumatologists. The survey plan consists of the following procedures:
Orthopedic deformity correction
Patients with fractures need to ensure an elevated position of the foot. The leg should be fixed with a splint; in case of a fracture without displacement, an immobilizing soft bandage is allowed. Apply cold to the foot to reduce swelling. To reduce the intensity of the pain syndrome, patients with injuries and an attack of gout can be given an analgesic or NSAIDs.
In case of fractures, reposition is performed, plaster is applied. With gout, a special diet is prescribed. Therapeutic tactics for most pathologies include the following activities:
A large number of surgical techniques have been developed for the treatment of Hallux valgus: Schede, McBride, chevron osteotomy, Scarf osteotomy, and others. The method is selected taking into account the severity of the pathology, the age of the patient and other factors. In addition, with deformities of the first toe, the following interventions are performed:
In the postoperative period, analgesics and antibiotics are prescribed, Baruk shoes are recommended. Restorative measures are carried out from the first days after the operation. Subsequently, it is advised to wear comfortable shoes, use orthopedic insoles.