Mounts foot (hallux valgus)

Monte foot is a structural deformity of the bones and joints of the plant and big toe. This can be painful. Represents expansion joint bone or tissue around the joint of the hallux-metatarsofalangiana.Angulation toward the toe may suffer next finger and tissue around the joints may be sore and sensitive.Today the term is used to refer to prominent pathological lateral big toe joint. Mount is actually an inflamed bursa sac and bone deformity that developed on joint metatarsofalangiana I.
Terms hallux valgus or hallux valgus abducto are most widely used in medicine for a mount, in which refers to thumb hallux valgus and refers to its abnormal angulation. Associated symptoms include irritated skin around mounts mount, outpatient pain, redness and joint pain, with a possible twist of the finger to other fingers.
Biomechanics are caused by an abnormality in which certain tendons, ligaments and supporting structures of the first metatarsal does not work correctly. This anomaly may be caused by a variety of conditions intrinsic structure of the plant, such as flat feet, excessive ligament flexibility, abnormal bone structure and some neurological conditions. These factors are often considered genetic. Although many doctors believe that shoes cause of the formation is too small mounts, other sources say this only exacerbates the problem caused by the deformation of the original genetic.
Mounts can be treated conservatively by modifying shoes, different ortoze, rest, ice and medication. These treatments address only symptoms of deformity correction. Surgery may be necessary if discomfort is severe enough or if you want to correct the deformity.
Pathogenesis
Leg mounts are associated with a deflected position of great toe toward the second toe and the deviation in angle between the first and the second metatarsal bone of the plant. Sesamoide behind the first metacarpal bones, which help to move the great toe flexor tendon can become diverted as the first metatarsal deviates from its normal position. Big toe joint arthritis, limiting movement and discomfort with pressure applied to the mount or mount joint movements can accompany development.
Causes and Risk Factors
Biomechanical instability:The most common etiology is difficult to understand and mechanical instability. Contributing factors, if present include: Gastrocnemius, gastrocnosoleus equinus, pes Planus flexible or rigid hipermobilitatea or short metatarsal.Arthritic and Metabolic Conditions:-Gout, rheumatoid arthritis, psoriatic arthritisEhlers-Danlos-syndrome, Marfan syndrome, Down syndrome-Ligament laxity.Neuromuscular conditions:Multiple-sclerosis, Charcot-Marie disease-Cerebral palsy.Traumatic conditions:-Merger abnormal intra-articular destructionSoft-tissue stretching, displacements.Structural Deformation:-Abnormal metatarsal lengthMetatarsus primus-elevatus-Genu varum or valgum-External tibial torsionFemoral-retrotorsiunea.
Signs and symptoms
Patients may present with pain onset with a sharp or deep nonacut first metatarsal during ambulatiei, with exacerbation during specific activities. The debut show intra-articular cartilage degeneration.The patient may also describe the form of cramping pain in the metatarsal head secondary to irritation by wearing shoes is improved if they are barefoot. This presentation is suggestive of superficial pain mount. Often both forms of pain are progressive and persist for many years. May increase the frequency or duration of pain recently, and activity worsens the pain. The patient reported an increase in size of the mount. Another possible clinical presentation is burning pain on the dorsal part of the mount showing the incarceration of the median nerve neuritis dorsal skin.The patient may describe symptoms caused by deformation, such as pain on the second finger, interdigital keratosis, or ulceration on the medial metatarsal head.
The diagnosis of hallux valgus
Laboratory studies:In general, laboratory studies are not necessary. If you suspect damage assessment Guto recommended to exclude gout uric acid. If there is collapse of the symmetrical metatarsals indicate rheumatoid factor assessment to rule out rheumatoid arthritis. If there is suspicion of infection should be evaluated by erythrocyte sedimentation rate to exclude infection.Imaging Studies:It recommended a radiograph of anterio-posterior and lateral plant to determine the type of surgery needed to correct mount.
Treatment of leg mounts:
An appropriate physical examination is needed to determine the etiology and treatment plan for specific deformation. Medical therapy can be used regardless of etiology but can not change adaptations cartilage, bone and soft tissue deformation.
Adaptive Shoes:Comfortable shoes, wide, high heel are blunt tip and therapeutic index.
Pharmacological and physical therapy:NSAIDs and physical therapy can provide improved acute inflammatory process, episodic. Corticosteroid injections may also be useful for acute inflammatory conditions of the first metatarsal joint.
Ortotica functional therapy:Ortozele are devices to correct anatomical position and a segment ambulatiei. Ortotica functional therapy can be implemented to control the foot biomechanics. This approach can improve symptomatic mounts, while the leg must retain a degree of mobility.
Surgical therapy:Procedures are chosen to correct a variety of pathologies associated with mountings:-Removing abnormal prominence of the first metatarsal boneMetatarsal bone-realignment from the rest of metatarsals-Strengthening against the first metatarsal and big toe adjacent fingersRealignment of the joint surface cartilage-halluxArthritic changes of the hallux Therapy-Repositioning metatarsal bones below the surface sesamoide-Shortening, lengthening, increasing or decreasing the first metatarsal bone-Correction and alignment projections abnormal abnormal big toe.Age, lifestyle and activity level the patient can play a role in choosing the procedure. Operation can be performed under local anesthesia, spinal or general. 6-8 weeks of recovery are needed to recover mobility.