WHAT AM I DOING?
The most important issue in hallux valgus surgery is not only removing the uncomfortable lump on the side of the thumb, but also removing the underlying factor that causes this condition (the underlying
For this reason, operations aimed only at removing the protrusion on the side of the thumb are far from yielding results and will result in the recurrence of the same deformity in the future. As a matter of fact, I have many new patients whose protrusion recurred as a result of previous surgeries performed with old techniques.
Another very important issue is that the same surgical treatment is not suitable for every hallux valgus patient. Nowadays, a single type of hallux valgus surgery is performed in most centers. The correct treatment approach is; It is to apply different techniques according to the degree and type of hallux valgus.
The important determining factors here are:
- Whether there is calcification in the thumb joint,
- The joint degree of angulation on its surface
- degree of angulation between the two fingers' metatarsal bones
- degree of angulation between the thumb and metatarsal bone
- hypermobility of the thumb metatarsal
- 2. or whether there is pain and callus under the third toes
- Whether flat feet are accompanied by
All of these criteria should be evaluated and the result-oriented technique should be applied.
THE SURGICAL TECHNIQUE I APPLY:
Modified distal metatarsal osteotomy, which is relatively simpler in mild and moderate cases and allows a very rapid return to daily life after surgery. ” technique.
In this technique, basically, the angle between the distorted thumb and the metatarsal bone is corrected by making an incision in the metatarsal bone, and then the bone is fixed in this position with the help of a titanium screw compatible with the body. In this way, the bone heals in this way and the deformity is prevented from occurring again.
After the surgery, the patient is taken to the recovery room and from there to his room. After a short rest period, the patient is put on post-operative shoes and immediately The patient is made to stand up and walk.
With this technique I apply, we can make the patient walk on the same day and the patient does not have any problems. He can bear weight on his foot without any pressure.
There is no need to apply any cast or use crutches.
The patient can be discharged on the same day or stay in the hospital for 1 night.
After 1 week, the patient comes for a check-up to check the stitching area. There is usually no need to remove stitches from the aesthetic (hidden stitching) wound.
Patients who work sitting can return to work within 3-4 days, for those who work standing and travel frequently. A few more days of rest are required.
The most important advantage in cases where these methods are used is; patients can immediately return to their daily lives. There is no need to use plaster or crutches. That's why we prefer to correct the deformity of patients with hallux valgus before it reaches advanced degrees.
In advanced cases; I apply a different technique than the one I explained above. In these cases, since the deformity of the metatarsal bone is greater, I correct the deformity closer to the arch of the foot. I also correct the area where the lump is located and provide correction from two different places. Thus, we provide a complete recovery in extremely deformed cases.
In addition, pain and callus formation in the metatarsal bone under the 2 fingers, which is a very common problem in these cases, is also eliminated.
After this technique, 4 days later. -The patient should not bear full weight on the side where the surgery was performed for up to 6 weeks. Again, no cast, crutches, etc. It is not used, there is no need for bed rest, the patient can return to his daily life.
This technique was most likely not used in patients who had surgery in the past and whose deformity or pain did not go away and recurred. If you have this type of history, your recurrent problem can be corrected with minor modifications to prevent it from recurring.
In cases where joint calcification is at the forefront; I perform modified resection arthroplasty surgery. The procedure performed in this surgery is to remove a part of the joint that does not function due to calcification, both to correct the deformity and to relieve the pain due to calcification.
This surgery is for young and old people. It is not suitable for active patients who have pores, because the strength of the thumb decreases after surgery. However, there is no change in the patient's walking, and even an improvement occurs as the pain decreases. There are no restrictions that will affect the patient's daily work.
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