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Acute Finger Injuries: Part I. Tendons and Ligaments

The severity of acute finger injuries is often underestimated, which can lead to improper treatment. Basic knowledge of the anatomy of the finger and a thorough evaluation of the patient can ensure proper diagnosis and treatment. Part I of this two-part article focuses on common tendon and ligament injuries of the finger. Part II1 discusses common finger fractures, dislocations, and thumb injuries.

Family physicians can manage most finger injuries; however, knowledge of referral criteria is important to ensure optimal outcomes. Treatment should restrict the motion of injured structures while allowing uninjured joints to remain mobile. Patients should be counseled that it is not unusual for an injured digit to remain swollen for some time and that permanent deformity is possible, even after treatment. Table 1 summarizes the evaluation and treatment of common ligament and tendon injuries.

Basic Anatomy of the Finger

The anatomy of the finger is complex, but a basic knowledge is necessary to properly treat acute injuries. The index, middle, ring, and fifth digits have proximal, middle, and distal phalanges and three hinged joints: distal interphalangeal (DIP), proximal interphalangeal (PIP), and metacarpophalangeal (MCP). The thumb has a distal and proximal phalanx as well as an interphalangeal and MCP joint. The joints sit in volar plates (collateral ligaments attached to dense fibrous connective tissue), which provide joint stability.2,3

The dorsal extensor tendon divides into a central slip that extends the PIP joint and then into two lateral bands that extend the DIP joint. The volar tendons include the flexor digitorum superficialis and the flexor digitorum profundus. The flexor digitorum superficialis tendon attaches to the base of the middle phalanx and flexes the PIP joint. The flexor digitorum profundus tendon is located under and splits the flexor digitorum superficialis tendon. It attaches to the base of the distal phalanx and flexes the DIP.4 Figure 1 illustrates the basic anatomy of the finger, including joints, ligaments, and tendons.

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Figure 1.

Anatomy of the finger. (A) Joints and ligaments. (B) Tendons.

Figure 1.

Anatomy of the finger. (A) Joints and ligaments. (B) Tendons.


Neurovascular and active flexion/extension testing will reveal clues to tendon and ligament injuries as well as subtle rotational abnormalities. The neurovascular evaluation should include two-point discrimination and capillary refill assessments. The physician should evaluate active flexion and extension by asking the patient to open and close his or her fist.

Clinical examination alone cannot diagnose fractures, and treatment protocols depend on radiography results. Patients with finger injuries should receive oblique, anteroposterior, and true lateral radiographic views.5 True lateral radiography is the most effective way to examine anatomic joint congruity.6,7 Ultrasonography is emerging as an effective tool to evaluate soft tissue structures. 8

The evaluation of finger injuries during an athletic event differs from an evaluation in the office. The primary goal on the field is to detect neurovascular compromise and determine if the athlete can safely continue participation. All on-field evaluations must be readdressed in the office for a more thorough examination including radiography. Failure to do so increases the risk of future dysfunction.

Common Injuries

Several techniques may be used to diagnose common ligament and tendon injuries. Most injuries require splinting and follow-up to evaluate the healing process.


Injury to the extensor tendon at the DIP joint, also known as mallet finger (Figure 2), is the most common closed tendon injury of the finger. Mallet finger usually is caused by an object (e.g., a ball) striking the finger, creating a forceful flexion of an extended DIP. The extensor tendon may be stretched, partially torn, or completely ruptured or separated by a distal phalanx avulsion fracture. 9

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Figure 2.

Injury to the joint extensor tendon at the distal interphalangeal joint (mallet finger).

Figure 2.

Injury to the joint extensor tendon at the distal interphalangeal joint (mallet finger).

Patients with mallet finger present with pain at the dorsal DIP joint; inability to actively extend the joint; and, often, with a characteristic flexion deformity. It is important to isolate the DIP joint during the evaluation to ensure extension is from the extensor tendon and not the central slip. The absence of full passive extension may indicate bony or soft tissue entrapment requiring surgical intervention.4,7,10 Bony avulsion fractures are present in one third of patients with mallet finger.11,12

If no avulsion fracture is present on radiographs, the DIP joint should be splinted in a neutral or slight hyper-extension position for six weeks13; the PIP joint should remain mobile. A Cochrane review14,15 confirmed that all available splints achieve similar results. Furthermore, the use of surgical wires (i.e., fixing the affected joint in a neutral position by drilling a wire through the DIP joint to the PIP joint) did not improve clinical outcomes.14,15 Figure 3 describes different types of splints.

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Figure 3.

Physicians should advise patients with mallet finger not to flex the DIP joint during treatment; the splinting period must restart every time flexion occurs. A Cochrane review15 showed that patient compliance is the most important factor in the success of splint treatments. The distal phalanx should be supported during splint changes.16 This is difficult to achieve alone, and the patient may need to return to the physician’s office for splint changes. Necrosis of the skin can occur if the DIP joint is overextended during splinting. If the skin blanches, the DIP joint is overextended. Allowing the skin to “breathe” for 10 to 20 minutes between splint changes minimizes the risk of maceration.

Patients may continue to participate in athletic events during the splinting period, and physicians should follow up with patients every two weeks to ensure compliance. After six weeks of splinting, the joint should be reexamined. If active extension is present, splinting can be limited to when the patient is sleeping and during athletic events for another six weeks.

Conservative treatment is successful for up to three months, even with delayed presentation.11 Referral criteria include bony avulsions involving over 30 percent of the joint space or the inability to achieve full passive extension. Despite proper treatment of mallet finger, permanent flexion of the fingertip is possible. The finger can become deformed if the injury is left untreated.17


Disruption of the flexor digitorum profundus tendon, also known as jersey finger (Figure 4), commonly occurs when an athlete’s finger catches on another player’s clothing, usually while playing a tackling sport such as football or rugby. The injury causes forced extension of the DIP joint during active flexion. The ring finger is the weakest finger and accounts for 75 percent of jersey finger cases.18 The injury can occur if the force is concentrated at the middle phalanx or at the distal phalanx.

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Figure 4.

Flexor digitorum profundus tendon injury (jersey finger). Note that the injured finger is held in forced extension.

Figure 4.

Flexor digitorum profundus tendon injury (jersey finger). Note that the injured finger is held in forced extension.

A patient with jersey finger may present with pain and swelling at the volar aspect of the DIP joint and the finger may be extended with the hand at rest. There may be a tender fullness if the tendon has been retracted. The digitorum profundus tendon should be evaluated by isolating the affected DIP joint (i.e., holding the affected finger’s MCP and PIP joints in extension while the other fingers are in flexion) and asking the patient to flex the DIP joint. 18,19 If the digitorum profundus tendon is damaged, the joint will not move. The flexor digitorum superficialis tendon should be evaluated by holding the unaffected fingers in extension and asking the patient to flex the injured finger.19 An injured flexor digitorum superficialis tendon will produce no movement. Figure 5 illustrates these techniques.

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Figure 5.

Evaluating flexor digitorum tendon injury. (A) The profundus test is performed by holding the affected finger’s MCP and PIP joints in extension and asking the patient to flex the DIP joint. The other fingers should be flexed at the MCP and PIP joints. (B) The superficialis test is performed by holding the unaffected fingers in extension and asking the patient to flex the injured finger. (MCP = metacarpophalangeal; PIP = proximal interphalangeal; DIP = distal interphalangeal.)

Figure 5.

Evaluating flexor digitorum tendon injury. (A) The profundus test is performed by holding the affected finger’s MCP and PIP joints in extension and asking the patient to flex the DIP joint. The other fingers should be flexed at the MCP and PIP joints. (B) The superficialis test is performed by holding the unaffected fingers in extension and asking the patient to flex the injured finger. (MCP = metacarpophalangeal; PIP = proximal interphalangeal; DIP = distal interphalangeal.)

The prognosis for patients with jersey finger worsens if treatment is delayed and if severe tendon retraction is present.20 Patients with confirmed or suspected jersey finger should be referred to an orthopedic or hand surgeon for treatment.18


Central slip extensor tendon injury occurs when the PIP joint is forcibly flexed while actively extended; it is a common injury in basketball players. Volar dislocation of the PIP joint also can cause central slip ruptures.21

The PIP joint should be evaluated by holding the joint in a position of 15 to 30 degrees of flexion. If the PIP joint is injured, the patient will be unable to actively extend the joint; however, passive extension should be possible. Tenderness over the dorsal aspect of the middle phalanx will be present. A delay in proper treatment may cause a boutonnière deformity (flexion of the PIP joint coupled with hyperextension of the DIP and MCP joints) (Figure 6). A boutonnière deformity usually develops over several weeks as the intact lateral bands of the extensor tendon slip inferiorly. Occasionally, boutonnière deformities occur acutely.

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Figure 6.

Boutonniére deformity caused by a central slip extensor tendon injury. (A) Normal alignment. (B) Boutonniére deformity.

Figure 6.

Boutonniére deformity caused by a central slip extensor tendon injury. (A) Normal alignment. (B) Boutonniére deformity.

The PIP joint should be splinted in full extension for six weeks if there is no avulsion or if the avulsion involves less than one third of the joint. All available splints (Figure 3) can be used to treat PIP injuries, except for the stack splint, which is used only for DIP injuries. As with mallet finger, extension of the PIP joint must be maintained continuously. If full passive extension is not possible, the physician should refer the patient to an orthopedic or hand surgeon.

Patients with PIP joint injuries may continue to participate in athletic events during the splinting period, although some sports are difficult to play with a fully-extended PIP joint. Splinting duration is the same as with mallet finger.


Forced ulnar or radial deviation at any of the interphalangeal joints can cause partial or complete collateral ligament tears. The PIP joint usually is involved in collateral ligament injuries, which are commonly classified as “jammed fingers.”

Collateral ligament injuries present as pain located only at the affected ligament. The injury should be evaluated by applying valgus or varus stress to the involved joint in 30 degrees of flexion while the MCP joint is flexed at 90 degrees; an extended MCP joint will tighten the collateral ligaments, inhibiting the evaluation. The physician should compare the laxity of the injured finger with an unaffected finger. Radiography may demonstrate an avulsion fracture at the ligamentous insertion point.

If the joints are stable and no large fracture fragments are present, the injury can be treated with buddy taping (i.e., taping the injured finger, above and below the joint, to an adjacent finger) (Figure 7). If the ring finger is involved, it should be secured to the fifth digit, because the fifth digit is naturally extended and easily injured if exposed.

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Figure 7.

Buddy taping for the treatment of finger injuries. (A) Self-adhesive wrap. (B) Velcro wrap.

Figure 7.

Buddy taping for the treatment of finger injuries. (A) Self-adhesive wrap. (B) Velcro wrap.

Patients with collateral ligament injuries may continue participating in athletic events as symptoms allow. If joints are unstable with active ranges of motion, patients should be referred to an orthopedic or hand surgeon. A low threshold for referral should exist for collateral ligament injuries in children, because the growth plate often is involved.7,11


Hyperextension of a finger joint, such as a dorsal dislocation, can injure the volar plate (Figure 8). The PIP joint usually is affected, and collateral ligament damage often is present. The volar plate can be partially or completely torn, with or without an avulsion fracture.11 The subsequent loss of joint stability may allow the extensor tendon to gradually pull the joint into hyperextension, causing deformity.

Figure 8.

Volar plate tear.

Maximal tenderness will be located at the volar aspect of the affected joint. Full extension and flexion will be possible if the joint is stable. The collateral ligaments should be tested as with collateral ligament injuries. Radiographs may show an avulsion fragment at the base of the involved phalanx.

A stable joint without a large avulsion fragment should be splinted with a progressive extension splint (“block splint”) (Figure 9) starting at 30 degrees of flexion7,22 for two to four weeks, depending on injury severity; buddy taping should follow. Increasing the extension of a dorsal aluminum splint weekly will progressively increase range of motion.22 In less severe injuries, the injured joint should be buddy taped. This will restrict some extension and provide support. These two techniques may allow a patient to continue participating in athletic events sooner; however, participation depends on the athlete’s sport and position; it is difficult to play some sports with a flexed PIP joint. Referral criteria include an unstable joint or a large avulsion fragment.

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Figure 9.

Progressive extension using a dorsal aluminum splint to improve range of motion.

Figure 9.

Progressive extension using a dorsal aluminum splint to improve range of motion.

Finger Sprains: Symptoms, Causes, Diagnosis, Treatment

A sprained finger is when you either stretch or tear one of the ligaments in your finger.  A ligament is a band of soft tissue. Most connect the outside surface of one bone to another bone.

A sprain is different from a strain, which is an injury to one of your muscles or tendons, the cords of tissue that connect your muscles to your bones.

Sprained Finger Causes

Common causes of finger sprains include:

  • An injury that causes your finger either to bend too far or bend in the wrong direction. If your finger bends backwards, it’s called “hyperextension.” For example, you might accidentally bend your finger in these ways during physical activities — especially in sports that involve using your hands, like basketball. You might accidentally jam your finger into a piece of equipment like the ball, or into another player, causing a sprain.
  • Falling on your hand. You’re more likely to get a sprain if you have problems with balance or coordination, which makes you more likely to fall, or if you have weak ligaments.

Sprained Finger Symptoms

If your finger is sprained, you might have:

  • Pain in one of your finger joints when you try to move or use it
  • Stiffness in your finger or having a hard time straightening or bending it
  • Tenderness in your joint when you touch the area
  • Swelling in one of your finger joints

Sometimes athletes who get sprained fingers ignore the injury. But the pain can be severe, and left untreated, it could get worse.

Sprained Finger Diagnosis

Your doctor will do a physical exam of your finger. You may also get imaging tests like an X-ray, and, in less common cases, an MRI.

If you do have a finger sprain, your doctor will assign it a grade based on how severe it is:

Grade 1: Your joint is stable but you have some stretching or microtearing in your ligament.

Grade 2: You have some mild instability in your joint and partial tearing in your ligament.

Grade 3: There’s significant instability in your joint and you’ve either severely or completely torn your ligament.

Sprained Finger Treatment

There are different treatments to help you feel better.


RICE therapy

Your doctor may recommend RICE therapy to manage your symptoms. RICE stands for Rest, Ice, Compression, and Elevation:


Rest: If a specific sport or activity caused your sprain, take a break from it for a while to help your finger heal.

Ice: Within the first 24 hours of your injury, you should apply ice to the area for 15 minutes at a time. If your symptoms last longer than that, you can do this for several days after the injury, too. This will ease any swelling or inflammation in your joint, and help ease the pain. Don’t put the ice directly on your skin. Instead, put it in a plastic bag or a cloth.

Compression: Your doctor may recommend that you wear an elastic compression bandage around your finger to provide support and prevent swelling.

Elevation: During the first 24 hours after your injury, try to keep your injured hand elevated to reduce swelling.

Your doctor may also suggest:

  • Anti-inflammatory medication (such as aspirin, ibuprofen, or naproxen) to help with your pain.
  • A finger splint.
  • Buddy taping, which is when you tape it to the finger next to it If you do buddy taping, make sure to tape your middle finger to your index finger and your ring finger to your pinky.
  • Surgery, if your injury is severe, meaning your ligament is completely torn or a piece of your bone has broken off.

Flexor Tendon Injuries | Hand and Wrist

Flexor Tendon Injuries


Tendons are tissues that connect muscles to bone. When muscles contract, tendons pull on bones, causing parts of the body to move. Long tendons extend from muscles in the forearm and attach to the small bones of the fingers and thumb. Tendons are kept in place next to the bone by snug tunnels called tendon sheaths. The extensor tendons on top of the hand are used to straighten the fingers. The flexor tendons on the palm side of the hand are used to bend the fingers.


A deep cut in the palm side of your hand, fingers, wrist or forearm is likely to damage or even sever the flexor tendons, which are quite close to the surface of the skin. Because tendons are under tension as they connect muscle to bone, the ends pull far apart when torn or cut, like a rubber band, making it impossible for the injured tendon to heal on its own. Without appropriate treatment, a flexor tendon injury can cause you to lose the use of your fingers, thumb or entire hand. A cut in this area of the hand may also involve important nerves and blood vessels, resulting in numbness or inadequate blood supply. Urgent surgery may be necessary.

Occasionally, flexor tendons may be partially cut or torn. With a partial tendon tear, it may still be possible to bend your finger, but not completely. These types of tears can be difficult to diagnose.


The most common signs of a flexor tendon injury include: a cut or open injury on the palm side of your hand, often where the skin folds as the finger bends; inability to bend one or more joints of the finger; pain when the finger is bent; tenderness along the finger on the palm side of the hand; and numbness in the fingertip.


In addition to cuts, certain sports activities can cause flexor tendon injuries. Participants of football, wrestling, rugby and other similar sports may suffer “Jersey finger,” where the tendon is pulled off the bone. During rock climbing and other activities that require extensive arm and hand strength, the tendons and/or sheaths may be stretched or torn. Certain health conditions (rheumatoid arthritis, for example) weaken the flexor tendons, making them more susceptible to tearing. Without warning or injury, a person may realize the finger no longer bends, without knowing how it happened.

Immediate First Aid

If you suffer a serious cut to your hand or fingers, apply ice immediately. Tightly wrap your hand with a clean cloth or bandage to slow down the bleeding, and keep your hand elevated above your heart. See a doctor as soon as possible for treatment, which may include a tetanus shot or antibiotics to prevent infection. Whenever your fingers are injured, even if the skin is not broken, it is very important to be examined by a physician. This is especially true if the finger is jammed and you cannot bend or straighten your fingertip.


In order to determine the extent of your injury, your physician will perform an examination that may include evaluating the strength of your fingers as well as your ability to bend and straighten them. Testing your hand for sensation and blood flow to the fingers will help verify if any nerves or blood vessels have also been injured. An X-ray may also be necessary to see if there is any damage to the bone.

Nonsurgical Treatment

Following the examination, your physician may place your hand in a splint for protection prior to surgery. If your tendon is partially torn, depending on the injury, your orthopaedic surgeon may recommend a nonsurgical treatment that includes the same splinting and exercise programs used for surgery patients.


Because the ends of a torn or severed tendon no longer touch, in most cases, it must be surgically repaired to heal properly. Typically, the sooner surgery is performed the better the outcome, so it is usually performed no later than 10 days after the injury. If the blood flow to your hand or finger is restricted, however, your orthopaedic surgeon may schedule your surgery immediately.

  • Surgical procedure—Tendons can tear in a variety of ways, including straight across, at an angle, or pulled off of the bone. There are various methods your surgeon may use to make the repair, but all involve special sutures, or stitches. Surgery is usually performed on an outpatient basis, allowing you to return home the same day. After the surgery, your doctor will place your fingers and wrist in a bent position to keep minimal tension on the repair, then apply dressing and splint to protect the repair and limit movement as the tendon heals.

It can take up to 2 months before the repair heals and your hand is strong enough to use without protection. Another month or so may be needed before your hand can be used with any force. Soon after surgery, you will begin physical therapy, performing specific exercises to help you gradually regain motion and function. Stiffness is common after surgery, but usually responds well to therapy. Wearing your splint and following your therapist’s instructions are as important to your recovery as the surgery itself.

Long-Term Outcomes

Flexor tendon surgery typically results in a good return of function and high patient satisfaction. However, this injury can be challenging to treat. Despite extensive therapy, some patients experience long-term stiffness. Occasionally, a second surgery to free up scar tissue is required to help the patient regain motion.

Hand tendon repair – Tests & treatments

When you can return home after having hand surgery will depend on how badly your hand was damaged.

You may be able to go home on the same day, after you’ve recovered from any anaesthetic and arrangements have been made for your aftercare.

After the operation

If you had a general anaesthetic, you’ll wake up in the recovery room after your operation. You may have an oxygen mask on your face and you may feel a bit drowsy.

If you had a regional or local anaesthetic, you’ll be able to go back to the ward sooner, but your arm will be numb and floppy for several hours.

It’s normal for your hand to be elevated in a sling (a large, supportive bandage) to help reduce swelling.

Following the operation, your hand is likely to be bruised and swollen and, when the anaesthetic wears off, it will be painful. You may need to take painkillers, such as ibuprofen, paracetamol or codeine for up to 2 weeks.

Before leaving hospital, you’ll be advised to keep your hand above the level of your heart whenever possible to help reduce swelling. For example, you may be advised to raise your arm on cushions while seated or hold your arm up to your other shoulder while standing and walking.

You won’t be able to drive for several weeks after the operation, so you’ll need to arrange for someone to pick you up and take you home from the hospital. If you live on your own and you’ve had a general anaesthetic, you may be advised to stay in hospital overnight. You may also need to stay overnight if you need hand therapy in hospital before you go home.

Recovery and rehabilitation

Before you leave hospital, a hand therapist may replace the rigid plaster splint (a support designed to protect the hand) fitted during the operation with a lighter and more flexible plastic one. This splint will help to prevent the repaired tendons from being overstretched.

You’ll usually be advised to wear the splint at all times for 3 to 6 weeks, possibly followed by just wearing it at night for a further couple of weeks.

Your hand therapist will tell you how to look after your splint and what to do if you develop any problems with it. It’s important to avoid getting the splint wet, so covering it with a plastic bag while having a bath or shower will usually be recommended.

You’ll be taught a number of different hand exercises after the operation, either before you leave hospital or at an appointment a few days later. The exercises will help prevent the repaired tendons getting stuck to surrounding tissue, which would reduce your range of hand movements.

The specific exercises recommended by your hand therapist or surgeon will vary according to the type of tendon repair you had.

If you smoke, it’s highly recommended that you stop because smoking can impair the blood circulation in your hand and delay your recovery time. Read more about stopping smoking.

Returning to work and activities

How quickly you can return to work and resume normal daily activities will depend on the nature of your job, as well as the type and location of your injury.

The repaired tendon will usually be back to full strength after about 12 weeks, but it can take up to 6 months to regain the full range of movement. In some cases, it may never be possible to move the affected finger or thumb as much as before it was damaged.

In general, most people are able to:

  • resume light activities, such as using a keyboard or writing with a pen, after 6-8 weeks
  • drive a car, motorcycle or heavy goods vehicle (HGV) after 8-10 weeks
  • resume medium activities, such as light lifting or shelf stacking, after 8-10 weeks
  • resume heavy activities, such as heavy lifting or building work, after 10-12 weeks
  • resume sporting activities after 10-12 weeks

Your hand therapist or surgeon will be able to give you a more detailed estimate of your likely recovery time.

It’s vital that you follow all the instructions and advice given to you regarding the use of your hands during your recovery period. If you attempt to use the repaired tendons before they’ve fully healed, it could cause the repair to rupture (break or split).

Sudden (Acute) Injuries | Florida Orthopaedic Institute

Treatment for sprains includes rest, immobilization, ice, compression, and elevation. An easy way to remember this treatment is to use the acronym RICE: Rest, Ice, Compression, and Elevation. This treatment should be used as soon as possible after a sprain to relieve pain and swelling, as well as promoting healing and flexibility.

  • Rest. Rest and protect the sore or injured area. Take a break, change, or stop any activity that is causing the pain or soreness.
  • Ice. Cold reduces pain and swelling. Apply ice or cold pack immediately to prevent and reduce swelling. Apply it for 10 to 20 minutes at a time – three or more times a day. If the swelling is gone after 48 to 72 hours, you can apply heat to the area.  Never apply ice or heat directly to the skin – place a towel between the cold or heat pack and the skin.
  • Compression. Wrapping the injured or sore area with an elastic bandage (such as an Ace bandage), helps decrease swelling. Don’t wrap too tightly as this can cause swelling below the affected area. Check the wrap and look for signs that the bandage is too tight (numbness, tingling, increased pain, coolness, or swelling) in the area below the bandage. If the bandage gets too tight, loosen it. If you think you need to use compression for longer than 48 to 72 hours, contact your doctor to make sure there’s not a more serious problem.
  • Elevation. Anytime you are sitting or lying down, raise the injured area with pillows while applying ice. If you can keep the area at or above the level of your heart, it will help minimize swelling.

Advil or Motrin (ibuprofen) and Aleve or Naprosyn (naproxen) are nonsteroidal over-the-counter anti-inflammatories that help relieve pain and swelling.

Minor sprains often heal well with home treatment but moderate to severe sprains need prompt medical evaluation and treatment. Your doctor may prescribe a cast or splint, physical therapy, medicine, or surgery. Recovery time for sprains varies depending on a person’s age and health, and the location and severity of the injury.


Skier’s Thumb is an acute injury to the ligament of the thumb, located on the inside of the thumb’s first knuckle. This ligament (the ulnar collateral ligament – UCL) provides stability for the thumb. The injury is commonly called Skier’s Thumb because it is seen among skiers who fall with their ski pole in their hand. The ligament can be partially torn, completely torn or stretched, and sometimes includes a small fracture of the thumb bone where the ligament is attached. Skier’s Thumb is also termed Gamekeeper’s Thumb.


Tendons are the strong and flexible fibers connecting muscle to bone.  As you move, they glide smoothly over muscles. Tendons vary in size and shape. Mallet finger (also known as baseball finger or drop finger) is when you try to catch a ball and your fingertip is struck by the ball with a lot of force. The tendon ruptures at the base of the finger joint. The result is a bent fingertip that can’t be straightened or is painful and swollen.


Overstretching muscles causes most strains. They can be severe, such as a torn muscle or tendon, or minor. Symptoms of a strain vary depending on the severity the strain and can include:

  • Pain
  • Tenderness (that is worse with movement)
  • Swelling
  • Bruising
  • Limited muscle movement
  • A bulge at the site of a complete tear

Recovery time for a muscle strain varies depending on a one’s age and health as well as the type and severity of the strain. While minor strains often heal well with home treatment, severe strains need medical treatment. If severe strains are not treated, long-term pain, limited movement, and deformity can result.


Fractures are breaks in a bone that can range from hairline cracks to bones broken into two or more pieces. Fractures can occur at the same time as other injuries, such as sprains, strains, or dislocations.

Signs and symptoms of fractures include:

  • A pop or snap at the time of injury
  • Pain that increases with movement or when pressure is applied
  • Swelling and bruising
  • Limited movement
  • Bone movement where there is no joint (for example, a bend in the arm between the elbow and wrist)
  • Bone poking through the skin
  • Bone visible in the wound

Fractures require medical attention, along with any other injuries that may have occurred at the same time. The broken bone may need to be set, cast, or splinted to help it heal. Depending on the type of fracture, it may need surgery.

Recovery time for a fracture can vary from weeks to months, depending on:

  • Age
  • Health
  • Type of fracture
  • Location of the fracture
  • Severity of the fracture

Other injuries may complicate treatment:


Dislocations are when a bone is pulled or pushed out of place, and out of its normal relationship to the other bones that make up a joint. This can happen in joints such as the kneecap, hip, finger, elbow, or shoulder.

Dislocation can be caused by direct blows to a joint, falls, or sudden twisting movements. Even everyday activities can cause dislocations if a person has unstable joints.

Dislocations can be problems even if the bone pops back into place. Soft tissues in or around a joint (such as ligaments, tendons, muscles, cartilage, and the joint capsule) can stretch or tear. Nerves and blood vessels can be damaged. Pieces of bone at the base of the joint can break off and end up inside the joint. Dislocations can cause fractures that extend into the joint.


Compartment syndrome develops when swelling takes place within an enclosed area (a compartment), in which muscles, nerves, blood vessels, and bones have no room to expand. Pressure on arteries, veins, and nerves causes extreme pain, slows circulation to the muscles and nerves, and can cause permanent damage to the tissue.

Swelling that causes compartment syndrome is usually caused by decreased blood flow, trauma, bleeding and fluid buildup. Compartment syndrome requires immediate emergency medical treatment to prevent tissue death and permanent dysfunction.

People involved in a greatly increased level of physical activity such as long-distance runners or new military recruits can develop chronic compartment syndrome. Symptoms are less sudden, less severe, and often improve with rest.


Anyone with a finger, hand, or wrist injury should immediately seek medical attention. Time is of the essence as the potential for permanent damage and destructive injury increases greatly when medical attention is delayed. Cuts and hand injuries need advanced treatment to prevent infection or loss of function, regardless of size.

A cut that may require stitches needs medical evaluation. If in doubt about whether a cut needs stitches, call a doctor for guidance.

Injuries to the hand with the following symptoms generally require emergency medical attention:

  • Severe bleeding
  • Numbness
  • Loss of motion or strength
  • Severe pain
  • Obvious deformity
  • Signs of infection (tenderness, local warmth, redness, swelling, pus, or fever)
  • Exposure of underlying structures (tendons, bones, joints, arteries, veins, or nerves)

Also, seek emergency medical care in these situations:

  • Fractures
  • Dislocations
  • High-pressure injuries
  • Amputations
  • Deep, gaping (open), or dirty cuts
  • Wounds from a human or bite (including cuts from striking a tooth during a fight)
  • Burns (if the skin is disrupted or if the burn goes completely around a finger, hand, or wrist)

Finger Sprain | Middle Georgia Orthopaedics, Warner Robins, GA

The bones in each of your fingers are connected by joints. A finger dislocation occurs when a bone in your finger is forced out of its normal joint position. With the joint separated, the finger loses most of its ability to bend and extend.

A direct blow to the hand, fingers, or thumb may cause a dislocation. Falls and contact sports, such as baseball and football, are commonly linked to finger dislocations.

Other factors may contribute to a finger dislocation such as:

  • previous injuries that have damaged the bone or soft tissues (ligaments)
  • using improper equipment during daily activities and exercise
  • diseases that affect the joints, such as rheumatoid arthritis

A sprain is an injury in which ligaments are overstretched or torn. Ligaments are strong bands of tissue that connect two bones together. Finger sprains occur when a finger joint is forced beyond its normal range of movement and a ligament is damaged.

Sprains are classified according to the extent of the injury:

    Mild (Grade I) sprains involve a tear of some of the fibers in the ligament. The finger is still functional and healing is usually rapid.
    Moderate (Grade II) sprains occur when part of the ligament is torn apart. There is some loss of function and healing will likely take longer than with a mild sprain.
    Severe (Grade III) sprains result when the ligament is torn completely apart or separated from the bone. Most finger movement is lost and surgery is needed to repair the damage.

What causes it?
Finger sprains are commonly caused by accidents, such as a blow to the finger or falling on an outstretched hand. They can also occur from activities that place repeated or prolonged stress on a finger joint.

What are the symptoms?
You may feel a tear or pop at the time of injury. This is followed by pain, swelling, and bruising in the area.

How is it diagnosed?
Your doctor will ask you about your injury and examine the finger. An X-ray of your wrist and hand may be needed to check for broken bones.

What is the treatment?
Conservative treatment usually includes rest and immobilization for the finger. You may need to wear a splint or have the finger “buddy-taped” to the finger next to it for approximately two weeks. Ice packs may be used for the first few days every three to four hours (10 to 15 minutes at a time) to reduce swelling. Your doctor may recommend anti-inflammatory medications to reduce swelling and pain. You may begin exercises to regain flexibility and strength in the finger when cleared by your doctor.

Severe sprains may require surgical treatment to repair the ligaments. Postoperatively, you may need to wear a protective splint for about four to six weeks. Your doctor may also refer you for hand therapy with an occupational or physical therapist.

What is the outlook?
Typically, finger sprains heal well in patients who follow their rehabilitation program. Ligaments require from two to 10 weeks to heal. A small number of patients do experience complications such as re-injury, joint instability, arthritis, or inflammation where the ligament attaches to the bone. Your recovery will depend on your age, overall health, and the extent of your injury.

What Are the Symptoms of Flexor Tendon Injuries?

Flexor tendon injuries can occur in your hand and finger, causing pain and interfering with your normal range of motion.

In this blog, Dr. Ather Mirza and Dr. Justin Mirza, orthopedic physicians at Mirza Orthopedics, outline some common symptoms of flexor tendon injuries.

What is a flexor tendon injury?

When you bend your fingers, you’re using flexor muscles that start at the elbow and are attached by tendons to the bones in your fingers. The tendons also pass through tunnels in your fingers, which keeps them close to the bones and allows them to work better.

The long tendons that extend from your wrist to attach to the bones on your palm are located close to the surface of your skin and can suffer injury. Each of your fingers has one flexor tendon that bends the middle joint and another that bends the middle and fingertip joints. Your thumb has one flexor tendon, which bends its tip.

These tendons can be injured in a variety of different ways.

What are the common causes of a flexor tendon injury?

Several types of traumatic events can cause injury to a flexor tendon. They include the following:

  • A deep or partial cut to the palm or one or more fingers
  • A rupture of the tendon caused by a sports injury. A common type is known as “jersey finger,” which can occur when you grab another player’s jersey, and it gets caught. As a result, the flexor tendon is pulled off the bone.
  • Stretching and tearing of the tendon caused by repetitive motion of the hand, fingers, wrist, or forearm during sports or other activities
  • Stretching and tearing of the tendon caused by severe rheumatoid arthritis

What are the symptoms of a flexor tendon injury?

A flexor tendon injury can cause any of the following symptoms:

  • Painful and swollen finger joints
  • Difficulty bending your finger joints or inability to bend these joints
  • Numbness in your finger – if the nerves that are located very close to your flexor tendon are also injured
  • Tenderness and pain on the palm side of the affected finger

What types of treatment are available for flexor tendon injuries?

Treatment options depend on the severity of the injury. In less severe cases, a conservative measure may sometimes be effective. They include the following:

  • Wearing a splint to help immobilize the affected finger, giving the tendon a chance to heal
  • Completing physical therapy designed to improve the strength and range of motion of the affected finger

In more severe cases, surgery may be needed to repair flexor tendons, and nearby nerves and blood vessels may also need to be repaired if they’ve been damaged.

Your orthopedic surgeon will find the cut ends of the tendon and hold them together with stitches, allowing them to heal back together. After the surgery, you’ll need to wear a splint to help protect the tendon as part of your recovery process. You’ll also need physical therapy to help ensure that your finger’s full range of motion is restored.

If you’ve suffered a flexor tendon injury, contact Mirza Orthopedics today for an evaluation. Our orthopedic physicians specialize in the diagnosis and treatment of conditions and injuries that affect the hand, wrist, elbow, and shoulder. We’re committed to delivering the most advanced, least invasive treatments possible that will alleviate your pain and restore your range of motion.

Subcutaneous rupture of the extensor tendon of the finger | ART-Clinic

This is a closed injury to the extensor apparatus of the finger, most often at the level of the distal interphalangeal joint.

The most common tendon injury. Trauma occurs as a result of a sharp unexpected bending (impact) on the nail phalanx of the finger, in the distal interphalangeal joint. The result is overstretching and rupture of the thin extensor tendon of the finger. In some cases, a bone fragment is torn off, to which the extensor tendon is attached.As a result, the extension of the nail phalanx of the finger is impossible. The so-called “hammer finger” is formed. In some cases, due to tendon degeneration, tendon rupture occurs with little effort.

Prices for the treatment of a rupture of the extensor finger tendon

Consultations of specialists

Appointment (examination, consultation) of a surgeon primary 1,500 rubles
Appointment (examination, consultation) of a surgeon repeated 1 500 rubles
Appointment (examination, consultation) of a surgeon, primary, no.MD, Professor Nerobeev A.I. RUR 5,000

Rupture of the extensor tendon

Suturing (re-fixation) of the extensor tendons at rupture old RUR 160,000
Suturing (re-fixation) of the extensor tendons with retraction with fresh

RUR 125,000
Suturing (re-fixation) of the flexor tendons at rupture RUR 110,000
Suturing (re-fixation) of the flexor tendons at rupture fresh – with tendon retraction RUR 125,000
finger RUR 120,000
Finger flexor tendon tenolysis RUR 120,000


Local anesthesia RUR 5,000
Intravenous anesthesia (20 TBVA) ₽ 90 014
General anesthesia (CETN).The cost depends on the duration of the operation (from 2 to 8 hours) from 30,000 rubles to 40,000 rubles

Hospital stay

Patient stay in the ward after general anesthesia (1 day) 10,000 ₽
Patient stay in the ward after intravenous anesthesia (day) 5,000 ₽

View full price list

Benefits of treatment in ART Clinic

Online consultations
for patients from regions

Team highly qualified specialists with extensive experience

Modern minimally invasive methods of operations and reconstructions

Affordable prices, promotions, discounts, installments

Briefly about the procedure

Duration of surgery

1 hour


local anesthesia

Removal of stitches

6-7 days


9000 2 1 day


2-3 times


After removal of sutures

More details about the procedure

Symptoms of a rupture of the extensor tendon

As a rule, an extensor injury is not accompanied by severe pain.Sometimes people only notice after a while that there is no active extension of the nail phalanx.

The finger can be painlessly extended with the other hand, but he cannot do it on his own. Swelling and soreness is possible, especially when a bone fragment is torn off.

Features of the operation

The priority method of treatment is to fix the nail phalanx with a wire for 5-6 weeks. The needle sinks under the skin and allows you to use your finger in everyday life.After removing the wire for several weeks, movement in the joint is fully restored. This operation is most effective in the first week after injury.

A more complex operation will be required if:

  • separation of the bone fragment more than 30% of the width of the articular surface
  • subluxation of the distal phalanx to the palmar side
  • the injury was more than 3 weeks ago

In these cases, the torn off tendon is sutured to the distal phalanx. If there is a fracture, the bone fragment is fixed with a wire.The nail phalanx is fixed in the position of moderate overextension with a wire passed through the joint so as not to tear the tendon suture.

Preparation for surgery

There are no special recommendations for preparation for surgery. On the day of surgery, do not eat or drink liquids in the morning. If you are taking medication regularly, take it with one sip of water.


  • Diseases that prevent anesthesia (discussed during consultation with a doctor)
  • Purulent-inflammatory diseases in the area of ​​operation

Postoperative period

In the postoperative period, it is necessary to take physiotherapeutic procedures aimed at reducing the density of the postoperative scar to process the place of operation with an anti-scar (contractubex, dermatics, etc.)) ointment.

It is necessary to exercise the finger in warm water (possibly with sea salt) after a light massage, in order to restore the range of finger movements. As a rule, finger movements are restored completely. Since the flexor tendon of the finger is stronger than the repaired extensor tendon, movement in the previously blocked joint will gradually recover.

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M 66.2, S 66.3 Subcutaneous rupture of the finger extensor tendon at the level of the distal interphalangeal joint

complaints by diagnosis

  • Pin deformation
  • Dysfunction of finger extension
  • Pain with finger movements

symptoms diagnosed

  • Deformation of the finger Flexion position (installation) of the distal phalanx of the finger.
  • Complete (often painless) passive finger extension Extension of the finger with the other hand.
  • Preserved function of other finger joints
  • Lack of active extension of the distal phalanx in the distal interphalangeal joint
  • Soreness on the palmar surface of the base of the finger during flexion and extension

a brief description of the diagnosis

Subcutaneous rupture of the extensor tendon of the finger of the hand at the level of the distal interphalangeal joint

A closed injury to the extensor tendon of the finger (subcutaneous rupture) is one of the most common injuries to the hand.Although initially insignificant, such damage can lead to dysfunctions of the hand that the victim is not ready to put up with. Externally, the finger is bent (bent) so that it begins to resemble a hammer, and therefore, this deformation is often called a “hammer finger”.

Only in half of the cases, the victims go to the doctor immediately, sometimes errors occur at the diagnostic stage with a doctor who is not a specialist in hand surgery, which ultimately leads to difficulties and unsatisfactory results of the treatment of this pathology.

In fresh cases (up to 7 days after injury), conservative treatment is possible – fixing the finger in a certain position in a special splint for a rather long period (6-8) weeks.

In stale and old cases, an operative method of treatment is preferable.

self-help for diagnosis

Fixation of the finger in the extension position with the help of improvised means (stick, plastic plate, etc.).

treatment regimen

average time of recovery

90,000 Joint development after injuries and operations

Rehabilitation of children and adolescents after injuries and operations. Joint development and limb rehabilitation.

The restoration of joint mobility in children and adolescents after injuries and operations is a necessary measure in the post-traumatic and postoperative period, even taking into account the fact that a young organism, in comparison with an adult, acquires the necessary functionality and performance much faster, which is due to the fact that they have more elastic and flexible soft tissues of the body, young energy makes you use the injured area earlier and the age of the patient plays a huge role in this matter.But, nevertheless, the VELM Rehabilitation Clinic has extensive experience in the rehabilitation of children in the fields of orthopedics and neurology, and, as a rule, these cases are when the need is urgently needed and has no alternatives.

Indications for the development of joints and the restoration of the upper and lower extremities after injuries and operations are – removal of immobilization with plaster of paris after fractures; operations on tendons, muscles and nerves; bone surgeries; operations on joints, as well as their endoprosthetics (replacement of a joint with its artificial analog).The causes of injuries, in the modern world, are the use of various entertaining devices in everyday life – for example, based on the experience of 70% of persistent contractures of the elbow joint in children, this is a consequence of the use of a herascooter.

“Before” and “After” rehabilitation course:

To achieve these results, the patient must be present in person at the VELM Rehabilitation Clinic by appointment, where a course of necessary procedures is prescribed, including: firstly, consultation with a rehabilitation specialist, or, if necessary, an orthopedic surgeon in order to determine the timing of rehabilitation, types of procedures used and their individual contraindications.Secondly, warming up the injured area before starting the manipulations. Thirdly, the rehabilitation specialist begins to massage the injured area, relieving muscle spasm, improving metabolism and blood circulation in the affected segment. Fourth, the rehabilitation specialist proceeds to manually develop the affected joint to restore its mobility. The final stage of the procedures is the passive development of the ARTROMOT apparatus of the German company ORMED, provided that this apparatus can be used in view of the age characteristics of the patient.This set of measures and procedures is applied until full mobility is restored.

Thus, the rehabilitation specialists of the VELM Rehabilitation Clinic help children and, most importantly, their parents to solve problems that have arisen in the post-traumatic and postoperative period:

1. Limited mobility of the limb and body associated with joint contracture.

2. Fear and uncertainty of the child to use the traumatized area, which arose in the post-traumatic and postoperative period, passes.This circumstance is due to the fact that the patient is clearly demonstrated his own motor abilities.

3. The result of the treatment will be a complete restoration of the range of motion in the joint.

General information about the proposed treatment and prices

You can get from the administrators by phone:

  • VELM-KONDI 8 (347) 216-2-216, +7 (917) 777-06-25;
  • VELM-Sipailovo 8 (347) 2-444-084, +7 (917) 473-24-16.

To determine the indications and contraindications, as well as the method, timing and nature of the complex of rehabilitation procedures, an in-person consultation with a doctor is required.

Rupture of the thumb ligament

Rupture of the thumb ligament accounts for about 70% of all injuries of visitors to ski resorts, in connection with which this acute condition is called “skier’s finger”. Chronic rupture or sprain is called the “huntsman’s finger”, which is also associated with the peculiarities of the profession.Tearing or stretching is caused by excessive abduction of the thumb, which can also happen when playing the ball. And the last, when this injury is possible, is the incorrect position of the thumb in wrestlers.

Treatment of a ruptured thumb ligament abroad can be carried out both conservatively and operatively. The choice of technique depends on the duration and severity of the injury, as well as on the type of patient’s activity. If an early return to physical activity is not required, where a hand is involved, then conservative means and special orthopedic constructions are used, and only if ineffectiveness is an operation is prescribed.

When the patient, due to the nature of his sports activity, cannot wait for conservative restoration of the joint, the treatment of rupture of the thumb ligaments is carried out with the appointment of an operation and subsequent professional rehabilitation. It is important that in case of chronic damage, complete rupture of tissues or ligament injury with separation of bone structures, treatment is possible only with the use of surgical intervention.

What will happen if the pathology is not treated? The consequences of trauma will constantly remind of themselves, interfering both in professional activity and in everyday life.It is noteworthy that with a complete old rupture, patients will not be bothered by pain at all, and instability is a symptom of pathology. The main symptoms of an acute rupture or sprain are pain and local tissue changes: swelling, redness, local fever, inability to move the joint.

Pain and instability of the joint can progress, and chronic inflammation will serve as a basis for the development of arthritic changes. Therefore, the treatment of a ruptured thumb ligament in clinics in Germany is recommended to be carried out as early as possible.

Diagnostics in Germany

Diagnosis of such a pathology as a skier’s finger, that is, an acute rupture of a ligament, is not difficult. Based on the anamnesis data, the doctor makes an assumption about the pathology variant and confirms the diagnosis by prescribing an X-ray examination. In addition to the rupture of the ligament, the X-ray will determine the presence or absence of damage to the bone structures.

For chronic damage, when there are doubts about the diagnosis, an MRI scan of the affected hand is prescribed.In addition to instrumental studies, compulsory general clinical analyzes are carried out. Also, if an operation is necessary, examinations are prescribed to determine the general condition, such as X-ray of the lungs and ECG.

Conservative treatments

Patients with a diagnosis of skier’s finger are prescribed treatment on the day of diagnosis, which determines the best prognosis for recovery. Usually, local anti-inflammatory drugs (creams, ointments) are prescribed, with severe pain syndrome, anesthetics are injected into the lesion.Among other drugs, vitamin therapy, restorative treatment is used, with severe pain syndrome – taking painkillers inside.

Also a mandatory stage of conservative therapy is wearing orthopedic structures and the use of an elastic bandage. In the acute period, treatment of a rupture of the thumb ligament abroad includes fixation of the structure and complete immobilization. The injured thumb should remain immobilized for four weeks.After that, complex orthopedic rehabilitation is prescribed using therapeutic gymnastics and special exercises that restore hand mobility.

Orthopedic rehabilitation, among other things, allows you to strengthen the ligaments of the hand, which prevents their repeated stretching and rupture. And if the patient returns to the kind of activity that led to the injury, the rehabilitation therapist gives certain instructions for the prevention of subsequent injuries.

Surgical intervention

Surgical treatment of a ruptured thumb ligament in Germany is carried out in a minimally invasive way – using arthroscopy.

Indications for surgical treatment are:

  • complete rupture of the ligament;
  • old damage;
  • ligament injury with separation of bone fragments;
  • the ineffectiveness of conservative therapy within 10-14 days.

During arthroscopic treatment, the specialist makes 2 incisions several millimeters long in the projection of the affected joint. This determines the minimum trauma to healthy tissues, which means the absence of postoperative complications and a relatively short rehabilitation.

A skier’s toe in Germany is eliminated by suturing the damaged ligament and restoring the integrity of the joint capsule. In addition, plastic surgery of bone structures (if necessary) is performed by applying fixing screws, plates and wire. Resorbable systems are often used, which are absorbed and eliminated from the body over time.

Rehabilitation and return to physical activity

After minimally invasive intervention, the patient remains in the clinic for 24 hours.On the morning of the day following the operation, a specialist examines the wound and can discharge the patient. It is quite possible to remove stitches in a domestic clinic, so the patient does not need to stay in Germany for a long time. Our team will always help the patient with regard to the control of treatment. You contact a DeutscheMedizinischeUnion consultant, provide the latest X-ray data, and we send the result to your attending physician abroad. After reviewing the image, the specialist gives further recommendations for your rehabilitation.

In addition, rehabilitation can be carried out in specialized orthopedic centers in Germany, which will also be helped by our team. However, rehabilitation begins 2-4 weeks after the operation. For all this time, an orthopedic splint is applied to the thumb joint, fixing it in a motionless state. At the same time, the wrist joint remains mobile, so the patient’s activity is somewhat preserved.

Note that after surgery, full load on the arm is possible only after 1-2 months, but conservative treatment, depending on the degree of rupture, may take 4 months.In any case, in a foreign clinic, you will be offered the optimal method of therapy, which will allow you to quickly eliminate the damage and return to your usual life. Leave a request on our website, and we will help you get treatment to the best orthopedists abroad.

Tendon injuries: diagnosis and treatment of tendon injuries in Odessa

As a result of injury, the muscles contract due to which the tendon sections diverge from each other, therefore, they cannot grow together on their own.The injury limits the ability of the limb to move, and is accompanied by acute and severe pain.

How tendon rupture occurs

Tendon is a complex structure that consists of bundles of collagen fibers and fibroblasts – tendon cells. Tendons are used to bind muscles to bones, which provide a person with movement. Due to the fact that in their structure the fibrous elements prevail over the cellular ones, the tendons are strong, withstand heavy loads and have low elongation.

The tendon part develops gradually, it grows most intensively after 15 and up to 25 years, and with the aging process, their elasticity decreases. Unlike muscles, tendons are much thinner and are short, long, rounded, narrow, wide, ribbon-like and cord-like.

The tendon ruptures most often at the site of its attachment to the bone. Tears along the length of the tendon are preceded by changes or chronic diseases in the tissues due to primary and frequent injuries.

Damage can be open or closed.When open, the integrity of the skin is compromised. Often these are deep injuries with sharp or cutting objects. Closed injuries are ruptures as a result of joint dislocations. At the site of the injury, swelling and hematoma are visible.

They can also be combined, isolated or multiple, given the number of lesions. Depending on the time elapsed since the injury, the damage is:

  • fresh – up to three days,
  • stale – up to 20 days,
  • old – more than three weeks.

Types of ruptures: causes and manifestations

Damage to the tendons of the fingers can occur in several areas on the hand. Each finger has several tendons, and they are often injured due to the fact that they are close to the skin and are poorly protected. The most difficult is damage to the extensor tendons, which occurs due to open injuries or strong blows of the hand on a hard surface.

This damage is followed by:

  • acute arm pain,
  • flexion disorders of the fingers,
  • limiting the work of the entire brush,
  • hemorrhage,
  • Lack of sensitivity in the finger.

Tendon ruptures in the shoulder area:

  • Rotator cuff rupture – rupture of muscle-tendon structures in the area of ​​the shoulder joint. It occurs due to strong muscle tension in this area, for example, during a fall on the elbow or a direct blow to the joint. The main symptoms are pain and limitation of movement in the joint.
  • Rupture of the biceps tendon is most common during contact sports and violent falls on the arm.Most susceptible to people with diseases or disorders in the joint. The rupture is accompanied by acute pain, swelling of the limb and dysfunction of the arm.

Quadriceps tendon rupture is a complete or incomplete rupture in or above the patella. It most often occurs in people after 40 years of age with severe loads on the leg or indirect injuries. In older people, rupture can occur without stress, as the tendon loses its elasticity.The trauma is accompanied by the sound of a pop or click. The gap can be felt as a depression develops just above the patella because the muscle is no longer connected to the patella. In this case, there is pain, instability in the stake, the inability to straighten the leg. The patella itself can sink below its location, and the knee swells a lot.

Achilles tendon rupture occurs due to injury or tension during muscle contraction. In a healthy state, this tendon can withstand just huge loads, and while running, a force acts on it, which is several times more than a person’s weight.Most often, the gap occurs during sports activities. The patient feels a sharp pain in the lower leg, cannot lean on the leg. Quite often, a hematoma occurs at the site of the rupture.

Methods for diagnosing tendon damage

Several types of studies are used to diagnose tendon rupture:

  • Ultrasound is more informative than X-ray, as it allows you to assess the degree of damage to tendons, muscles and ligaments. It is often used for dynamic monitoring of the condition of the affected organ.
  • Magnetic resonance imaging is a modern and commonly used method that allows you to study the location and extent of the rupture. The method is shown even to children, does not carry radiation and allows to identify concomitant pathologies in the structure of joints.
  • Diagnostic arthroscopy is a surgical research method in which an arthroscope is inserted into the cavity of the affected joint through several small punctures and the condition of the joint is examined from the inside. This allows you to evaluate all structures and parts of the joint.The method is minimally invasive, which does not leave large scars, but provides a complete picture of the trauma, which accompanies successful treatment and the absence of surprises during the operation.

Methods for the treatment of tendon ruptures

The choice of treatment tactics depends on the nature of the damage. If the gap is partial, it is possible to use conservative methods, but if the gap is complete, it is necessary to operate.

In case of tendon ruptures in the area of ​​the fingers and hand, various splints are applied to the damaged area.If surgical treatment is necessary, the method of hand microsurgery is used. The surgeon can use different types of sutures, depending on the department of damage. Often, ruptures are accompanied by damage to other structural elements of the hand, such as nerves or blood vessels. To return the hand to motor function, during the operation it is necessary to restore all damaged elements.

Rupture of the biceps brachii is treated only by surgery. During the intervention, the end of the tendon is fixed and attached to the humerus.
A Partial rupture of the quadriceps femoris tendon is treated with a splint on the leg. Complete tears require suturing of the tendon.

Benefits of treatment at the Odrex Medical House

Treating a ruptured tendon requires prompt medical attention, accurate diagnosis, and surgical prowess. Experienced orthopedic traumatologists are on duty 24/7 at the Odrex admission department, who are trained not only in Ukraine, but also abroad. They provide emergency care and, if necessary, perform urgent operations.

The Odrex Medical House uses a new generation of equipment, which allows fast examinations with high accuracy. All surgical interventions are carried out in accordance with international standards and the most modern techniques. This allows the patient to quickly return to normal life and restore the functionality of the injured limb.

Treatment of hallux valgus: Minimally invasive surgery helps to correct the position of the 1st toe

Information: Types of surgery to correct hallux valgus

  • Duration of hospital stay: 2 days
  • Outpatient rehabilitation: 2 weeks
  • Earliest flight home: 5 days after surgery
  • Recommended time to fly home: 7 days after surgery
  • Showering possible: 12 days after surgery
  • Duration of incapacity for work: 28 days (depending on the type of activity)
  • Removal of stitches: after 12 days
  • Driving possible: after 14 days

Dr.Thomas Schneider, Orthopedic Expert Consultant for Foot and Ankle Surgery

Fig. 1: Surgical treatment of hallux valgus restores the mobility of the 1st toe. Often, our foot specialists resort to osteotomy of the main phalanx of the 1st toe in combination with soft tissue correction of the articular capsule of the 1st metatarsophalangeal joint. ©

Do you feel that the 1st toe begins to deviate more and more outward, as well as displace the smaller toes? After a long walk or already in the morning, do you feel severe pain in your foot, limiting your mobility and mobility in everyday life? Then, like many other patients of the orthopedic department of our renowned clinic in Freiburg, you suffer from Hallux valgus (hallux valgus), during which a bony protrusion forms on the inside at the beginning of the 1st toe (“bone” or “bump” ).

At the orthopedic clinic Gelenk-Klinik, every foot specialist can perform high-quality, gentle treatment of deformities of the first toe with minimally invasive forefoot surgery without complications. This fact greatly accelerates the recovery and rehabilitation period, to which both German and foreign patients pay great attention.

Treatment of hallux valgus in the orthopedic clinic Gelenk-Klinik is aimed at quickly restoring the mobility of each patient, as well as improving the cosmetic appearance of the foot.

Treatment of hallux valgus

The goal of the surgical treatment of hallux valgus is the restoration of a mobile foot with a cosmetically beautiful shape, capable of bearing loads.

In this article we will tell you which goals of Hallux valgus surgery are realistic.

We draw your attention to the fact that with more serious hallux valgus it implies more complex treatment. Therefore, if you are suffering from an unpleasant disease, we recommend that you contact a specialist in advance who will tell you about the gentle methods of correcting the disease.

What does Hallux valgus mean?

Hallux valgus (crooked toe) is one of the most common diseases of the 1st toe. With this pathology, damage to the transverse arch of the foot occurs at the base of the 1st toe. The 1st toe deviates noticeably towards the outer edge of the foot and displaces the smaller toes. In this disease, the 1st metatarsophalangeal joint is subject to excessive stress, which can lead to prolonged and painful arthrosis (Hallux rigidus).

When the disease develops, the skin over the bony prominence on the 1st metatarsophalangeal joint becomes inflamed and painful, a “bump” or “bone” begins to interfere with walking. Treatment of hallux valgus, as well as pain relief, can be carried out using various conservative methods. By clicking on this link, you will receive the necessary information on the topic “Diagnostic and conservative treatment of hallux valgus”.

Indications for surgery: In what situations is the surgical treatment of hallux valgus performed?

Bursitis of the 1st toe – inflammation of the mucous membrane of the joint bag

  • Due to the constant pressure of the wrong shoes, the bony protrusion (“bump”) becomes inflamed.
  • Curvature of the toes (hammer and hook toes) is the cause of additional deformities of the metatarsus.
  • Arthritic pain in the 1st metatarsophalangeal joint appears due to wear and tear of the joints.
  • Arthritic pain in the metatarsophalangeal joint occurs due to wear of the joint.

For many patients who prefer open shoes, the problem of hallux valgus is primarily a cosmetic problem.As a rule, only because of the unaesthetic appearance of the foot, treatment of hallux valgus is not performed. Despite this, during the planning and carrying out of the plastic surgery of the foot, our specialists, who offer the treatment of hallux valgus, attach great importance to the cosmetic result. Thus, the doctors of the Gelenk-Klinik in Freiburg provide the patient with professional treatment for the disease and help improve his quality of life.

In order to carry out surgical treatment of hallux valgus, the disease must be pain-free.Also, we would like to draw people’s attention to the fact that a full-fledged treatment of hallux valgus is impossible by replacing shoes, using special orthopedic devices and even targeted gymnastics for the feet. Orthopedic insoles certainly help relieve pain, but they cannot correct the deformity itself.

Surgical treatment of hallux valgus of the 1st toe: Cosmetic result

  • Straightening of the 1st toe.
  • Normalization of hammer and hook fingers.
  • Removal of the inflamed “bump” (removal of osteochondral exostoses).
  • Minimal scarring.

For medical reasons, surgical treatment of hallux valgus is offered when the patient feels pain in the foot and is unable to move as before.

If conservative treatment of hallux valgus is unsuccessful, specialists begin to plan the operation. Surgical intervention is performed approximately 6 months after conservative therapy.

Conservative treatment of hallux valgus is aimed at eliminating pain and preventing the progression of the disease. The final treatment of hallux valgus of the 1st toe using conservative methods is possible only on a growing skeleton, that is, if the patient is still young and his body is growing and developing.

The plan for the operation of hallux valgus is compiled strictly on an individual basis

In the treatment of Hallux valgus, concomitant diseases are also taken into account

  • Exostosis on the lump
  • Arthrosis of the first metatarsophalangeal joint (Hallux rigidus).
  • Bursitis – inflammation of the mucous bags in the joints.
  • Bursitis of the small fingers.
  • Transitional metatarsalgia (painful overload of the small fingers)
  • Hook fingers
  • Hammer fingers

Hallux valgus always occurs in combination with various painful processes. So, in addition to hallux valgus of the 1st finger, the patient may experience skin changes or inflammation of the mucous membrane (bursitis). A curved toe displaces adjacent small toes, resulting in overload.Before drawing up a plan for the operation, the specialists of our clinic will carry out an accurate diagnosis and determine the degree of development of the disease. Below, your attention will be presented in detail the standard operations for hallux valgus. In addition, we draw your attention to the fact that in this disease, in order to refer a patient for surgery, we first need to understand his individual situation and assess the degree of hallux valgus.

Surgical treatment of hallux valgus is performed only by highly qualified specialists with many years of experience.The surgeon discusses all the details and features of the upcoming intervention with the patient in advance.

Treatment of hallux valgus. Video

Surgical treatments for hallux valgus
Most hallux valgus surgeries consist of several of the following procedures:

  • Corrective osteotomy of the proximal metaepiphysis of the 1st metatarsal bone:
    Helps to straighten the 1st toe.
  • Soft tissue correction (lateral release of the joint):
    In case of adequate release, the 1st toe was effortlessly placed in the required position.
  • Tendon Correction:
    Tendon length correction is necessary to prevent re-injury of the 1st toe.
  • Treatment of the 1st metatarsophalangeal joint:
    Joint-sparing cheilectomy (extraction of a bone spur), with progressive arthrosis – immobilization (arthrodesis) of the 1st metatarsophalangeal joint.

Only when all the possibilities of conservative treatment of the disease have been exhausted, orthopedics in Germany offers operations to correct the hallux valgus of the first toe.Among the long-term and painful consequences of hallux valgus, arthrosis of the 1st metatarsophalangeal joint is distinguished.

How can a patient prevent surgery?

Timely replacement of uncomfortable shoes with special ones that create the necessary space for the toes and regular treatment without surgery prevent the development of the disease. Therefore, after the appearance of a bony protrusion on the foot, immediately consult a specialist.

What to do if conservative treatment of hallux valgus does not bring the desired results?

Due to the increasing immobility of the 1st metatarsophalangeal joint and damage to the adjacent toes, surgical treatment of hallux valgus becomes more difficult.

Prolonged subsequent injuries to the foot such as Hallux rigidus (arthrosis of the 1st metatarsophalangeal joint) become more intense and painful.

After the surgical correction of the first metatarsophalangeal joint, every patient is happy that he no longer feels the same pain and can walk normally. Also, the patients are very satisfied with the good aesthetic result of the operation.

Purpose of surgery for hallux valgus: Beautiful feet without pain

Fig.2: Foot with hallux valgus: A clear image of the bony prominence of the 1st toe. The sesamoid bones (small bones located in the thickness of the tendons and, as a rule, lying on the surface of other bones) of the long flexor of the 1st toe are located under the 1st metatarsophalangeal joint in an eccentric position: They surround the bones of the toes not symmetrically and are displaced to the side … © Dr. Thomas schneider

In addition to straightening the 1st toe, surgical treatment of Hallux Valgus in the early stages also implies the preservation of the first metatarsophalangeal joint affected by arthrosis.Thus, an effective and long-term correction of the malposition of the 1st toe is achieved. Only in the case when the feet acquire their previous shape, it is possible to restore the natural gait: With a healthy gait, the step “rolls”, smoothly and slowly from heel to toe, in the case of foot deformities – the biomechanics of the 1st metatarsophalangeal joint is disturbed. The other toes are responsible for the rolling process of the foot, as a result of which an excessive load is exerted on them, which eventually leads to hallux valgus.

The main task of the surgical treatment of this pathology is to perform excision of the apex or edge of the first metatarsophalangeal joint, as well as to remove and match the soft tissues and bones of the foot in order to reduce pain, restore internal rotation (pronation) and the previous configuration of the joint.

The main task of the surgical treatment of this pathology is to perform excision of the apex or edge of the first metatarsophalangeal joint, as well as to remove and match the soft tissues and bones of the foot in order to reduce pain, restore internal rotation (pronation) and the previous configuration of the joint.

Contraindications and other problems of surgical treatment of hallux valgus

Fig. 3: Circulatory disorders are one of the main reasons why surgical treatment should not be performed: With occlusion of peripheral arteries or diabetic foot, the wound healing process is more difficult and takes much longer. © Viewmedica

Surgical treatment of hallux valgus: Contraindications
The main contraindication is atherosclerosis obliterans of the peripheral arteries.Impaired circulation can slow down the healing process of a postoperative wound.

For the final recovery after forefoot surgery, good blood circulation is essential. The foot is the organ of movement farthest from the heart. The soft tissues of the foot, which bear the load, are very thin, but the mechanical load is very high. Therefore, all circumstances that negatively affect blood circulation slow down the recovery process of the foot after surgery.The following conditions prevent the successful outcome of forefoot surgery:

  • Atherosclerosis obliterans of peripheral arteries
  • Diabetic foot and initial stage of polyneuropathy (systemic peripheral nerve damage due to diabetes)
  • Polyneuropathy (nerve condition related to diabetes)

In these cases, before prescribing surgical treatment to the patient, our specialists conduct a more serious examination and determine the state of blood flow.

Polyarthritis, as well as rheumatic diseases are not contraindications to surgical treatment of hallux valgus. However, with these diseases, it is necessary to pay attention to the choice of the surgical method.

Previous surgical treatment of the forefoot complicates the process of carrying out the displacement intervention and may negatively affect the desired result.

Surgical method is selected depending on the degree of hallux valgus

There are many internationally recognized and well-proven surgical techniques for correcting such deformities.As the orthopedic clinic Gelenk-Klinik is one of the most renowned orthopedic clinics in Germany with the most innovative technologies, every patient will be offered Hallux valgus treatment at the highest level.

The stronger the deformity, the more difficult the operation.

In this case, the following rule applies: The stronger the deformity of the foot, the more difficult it will be to undergo surgical treatment of hallux valgus. The stronger the damage, the longer the recovery process and postoperative treatment will take.If the treatment is carried out at a progressive stage of the disease, which is often accompanied by arthrosis of the big toes, then the long-term result, as well as the restored physical endurance, will be the same as in the treatment of milder forms of the disease.

In the first degree of hallux valgus, intervention on soft tissues is most effective, which is quite often performed in combination with the technique of excision of the bone protrusion and the subcutaneous mucous membrane in the area of ​​the 1st metatarsophalangeal joint.In the second stage of the disease, the operation is performed on the metatarsal bone. In the case of severe hallux valgus, specialists carry out surgical treatment, the purpose of which is to displace or immobilize the metatarsophalangeal joint: The connecting link between the metatarsal bone of the ray of the foot with the bones of the tarsus.

These methods, aimed at restoring the position of the 1st toe and 1st metatarsophalangeal joint, are often performed in combination with interventions on soft tissues (muscles, capsules and tendons).

What treatment the doctor chooses depends on the anatomical location of the deformities, as well as on their stage. In any case, before prescribing one or another suitable treatment for hallux valgus, the orthopedist discusses all the necessary details with the patient: After conducting proper clinical studies and X-rays, the doctor will be able to finally determine which treatment for hallux valgus you need.

The choice of an operating technique that allows this lesion to be treated depends on the degree of hallux valgus (intermetatarsal angle = between 1 and 2 metatarsal bones).

Surgical treatment of Hallux valgus using these methods refers to the anatomical parts of the foot indicated below.

Operation for the first metatarsophalangeal joint

Distal osteotomy is the most common technique for correcting hallux valgus.

Minimally invasive surgical treatment of mild and moderate hallux valgus

The specialists of our clinic in Freiburg try to carry out surgical treatment of this disease with minimal bone displacement and minimal scarring.Our goal is to correct Hallux valgus using only soft tissue surgery. Today, unfortunately, this is not entirely possible: Modern surgery still uses special screws and implants to fix the bones.

The minimally invasive surgical treatment is “distal displacement”: During this intervention, the 1st toe is displaced starting from the 1st metatarsophalangeal joint (“distal”). This treatment is carried out by our specialists for mild deformities or for moderate deformities of the foot.

Surgical treatment of hallux valgus using well-tolerated titanium screws often does not entail repeated intervention for their removal. Titanium screws usually do not need to be removed. After this operation, the patient does not feel any discomfort.

Our doctors offer this treatment to patients with hallux valgus of the foot of mild or moderate severity. Such an operation guarantees a good cosmetic result with minimal scarring.

If, due to hallux valgus, you have already developed arthrosis of the first metatarsophalangeal joint, minimally invasive treatment is no longer possible. In this case, our orthopedic surgeons will perform a more traumatic operation that will give you a chance to get rid of the lump.

How is minimally invasive surgical treatment of hallux valgus carried out?

During the operation, the surgeon makes two small incisions on both sides of the thumb. Due to the low trauma of the operation, soft tissues are almost not affected, as a result of which the healing process of the suture is shortened, and the percentage of complications is significantly reduced.In the case of open surgery for hallux valgus, the situation looks quite different.

The minimally invasive surgical treatment of this disease straightens the oblique position of the foot bones using small surgical instruments similar to dental equipment. At the next stage of the operation, through a small incision, the shortened joint capsule is opened and expanded, which allows creating the necessary space for the normal alignment of the 1st toe.

Compared to other minimally invasive techniques, lateral release (tightening of the medial joint capsule) has several advantages: Damage to soft tissues is minimized. Also, the low trauma of this operation. helps to reduce the recovery process. Thanks to lateral release, older patients become mobile in a short time. In addition, due to the minimal stress on soft tissues, postoperative foot edema is significantly lower than after other surgical procedures.

Osteotomy Akin – wedge-shaped osteotomy of the main phalanx of the first toe in case of mild hallux valgus

Osteotomy Akin

Slight valgus deformity of the distal interphalangeal joint: Isolated deformity of the 1st toe outside the 1st metatarsophalangeal joint.

In order to correct the valgus deviation of the distal phalanx of the 1st toe (Hallux valgus interphalangeus), our specialists perform surgical treatment using the Akin Osteotomy method.

During this procedure, the position of the 1st toe is corrected outside the 1st metatarsophalangeal joint (Metatarsus interphalangeus) – a change in direction using a displacement osteotomy. Akin’s osteotomy is not able to completely correct the hallux valgus. For this reason, this intervention is combined by orthopedic surgeons with other surgical techniques aimed at treating hallux valgus.

Change of direction during Akin Osteotomy is achieved by removing a bone wedge from the 1st toe.Thus, the bone grows together in a new, more correct position.

Also, this operation to eliminate angular deformity contributes to the normalization of tendon cords on the 1st toe.

Treatment of hallux valgus .: Osteotomy of the 1st bone of the pusna (correction of the metatarsal part of the foot)

Chevron osteotomy: Surgical treatment of Hallux valgus on the metatarsal bone for moderate hallux valgus

Fig.7: Planning a chevron osteotomy behind the 1st metatarsophalangeal joint. In a chevron osteotomy, a small V-shaped incision is made behind the 1st metatarsal head, which is then pushed outward and fixed with a titanium screw © Dr. Thomas schneider

Fig. 8: Treatment of hallux valgus with chevron osteotomy with fixation with self-tapping titanium wines ©

Surgical treatment A chevron osteotomy is performed for moderate hallux valgus.The specialist will offer such treatment to the patient if he has arthrosis of the 1st metatarsophalangeal joint. During a chevron osteotomy, a small V-shaped fragment is removed at the level of the metatarsal head.

During the operation, the head of the metatarsal bone is pushed outward, after which it is fixed with a titanium screw, which helps to stabilize its position. To restore the normal direction of the 1st toe, the surgeon contracts the joint capsule from the inside.

With mild hallux valgus (<17 °), such significant joint changes such as arthrosis of the first metatarsophalangeal joint are not observed.Therefore, in this case, this treatment is most appropriate. Thus, the surgical treatment of chevron osteotomy is offered to patients suffering from mild to moderate hallux valgus.

Treatment of hallux valgus. Chevron osteotomy: Progress of the operation.

In a chevron osteotomy, first, on the dorsum of the foot above the first metatarsophalangeal joint, the surgeon makes a small incision. Then the separation and expansion of the joint capsule and ligaments shrunken due to hallux valgus is performed (soft tissue surgery).

Thus, the compression of the ligaments and the articular capsule, contributing to the strengthening of the hallux valgus of the 1st toe, is eliminated.

After that, the bone growth is removed using special surgical instruments. On the 1st metatarsal bone – at the level of the metatarsal head – the surgeon makes a small incision. Then he pushes the head of the metatarsal bone towards the little finger until he places it under the sesamoid bones.

After that, the bone of the toes is fixed with a self-tapping titanium screw or titanium wire, after which the articular capsule is straightened again.Small titanium screws usually remain in the bone and cannot be removed. However, if the titanium screws cause any inconvenience to the patient, the surgeon can remove them on an outpatient basis no earlier than three months after the operation.

Fig. 9: Chevron osteotomy: side view. Fixation with self-tapping titanium screw. Healing toes in a new right direction. © Dr. med. Thomas schneider

With more significant deformities of the foot, changes in the joints and articular capsule are very often observed.To eliminate them, in addition to chevron osteotomy, soft tissue surgery is performed.

In the presence of the necessary indications, the treatment of hallux valgus using the chevron osteotomy method allows the surgeon to perform lateral displacement of the 1st toe. To avoid recurrence of the disease, we recommend that you check the position of the sesamoid bones using an intraoperative X-ray (EOP-X-ray) already during the intervention to correct the hallux valgus.

Scarf-Osteotomy: Surgical treatment of moderate to severe hallux valgus

Surgical treatment Scarf-Osteotomy is used by surgeons in cases of moderate to severe hallux valgus.SCARF osteotomy is a Z-shaped osteotomy of the 1st metatarsal bone. Also, SCARF osteotomy is a fairly well-known surgical method for treating hallux valgus, during which correction is performed on the 1st ray of the foot. At the first stage of the operation, using a small skin incision, the surgeon opens the metatarsal bone of the 1st ray of the foot, after which he cuts a Z-shaped wedge from the side of the 1st metatarsal bone. Thus, with the help of small locking screws, the 1st metatarsal bone is fixed and displaced into the correct angle.In order for the sesamoid bones, which are located on the tendons, to quickly take the desired position, it may be necessary to correct the soft tissues on the articular capsule of the 1st metatarsophalangeal joint.

Scarf-Osteotomy is the most suitable method for correcting moderate to severe hallux valgus (17 ° to 40 °). Also, the treatment of hallux valgus with Scarf-Osteotomy is used to treat the curvature of the big toe around its longitudinal axis.In addition, this surgical treatment is carried out together with the intervention on the soft tissue apparatus of the 1st metatarsophalangeal joint (tendons and capsules), as a result of which the tendon-muscle balance is normalized.

Treatment of hallux valgus with Scarf-Osteotomy. Operation progress.

During a Scarf Osteotomy, the surgeon makes an incision on the inside of the foot from the base of the toe to the base of the metatarsal bone. Then a Z-shaped wedge is excised from the 1st metatarsal bone. After that, the head of the metatarsal bone of the 1st toe, which forms the metatarsophalangeal joints, is displaced outward to the correct angle.

In order for this displacement to occur without any tension, the surgeon changes the position of the tendons pulling the 1st toe towards the center.

The joint capsule damaged due to hallux valgus is detached, after which the bone is fixed with two small titanium screws.

T Large bone contact surface for optimal healing. Installed titanium screws usually remain and cannot be removed. In the event that titanium screws cause any inconvenience to the patient, the surgeon can remove them on an outpatient basis no earlier than three months after the operation.

Surgical treatment of the 1st metatarsophalangeal joint

In case of progressive arthrosis of the 1st metatarsophalangeal joint, surgical treatment is required.

Arthroscopic cleaning of the 1st metatarsophalangeal joint, as well as removal of bone spurs, is performed with the help of joint-preserving resection of exostosis of the head of the 1st bone of the pusna (cheilectomy). In the case of arthrodesis of the metatarsophalangeal joint, both bones of the phalanx of the finger and metatarsal bone are connected in a certain position, as a result of which bone fusion is achieved.

Treatment and stabilization of the 1st metatarsophalangeal joint can also be performed using a special semi-prosthesis.

Lapidus arthrodesis: Surgical treatment of hallux valgus aimed at immobilizing the joint between the metatarsal bone and the foot (tarsometatarsal joint surgery)

Lapidus arthrodesis is the most suitable treatment for severe hallux valgus accompanied by arthrosis and instability in the first metatarsophalangeal joint of the 1st ray of the foot.

During this operation, the first metatarsal bone and the tarsal bone are fused.

The most effective surgical treatment for Lapidus arthrodesis is in severe hallux valgus with a particularly pronounced displacement angle (> 40 °) or in arthrosis of the tarsometatarsal joint.

Predictions and complications after surgical treatment of hallux valgus

Treatment of hallux valgus: Possible postoperative complications

  • Chronic pain.
  • Soreness from using titanium screws or titanium fixing wires.
  • Change in gait due to load redistribution.
  • Fatigue fractures or stress fractures due to load changes after surgery.
  • Fatigue fractures or stress fractures due to load changes after surgery.
  • Infections

In order for the treatment of hallux valgus to be successful, it is necessary to weigh the pros and cons of the forthcoming surgery to correct hallux valgus.According to international studies, more than 80% of patients with hallux valgus helped to regain their previous lifestyle. Despite postoperative complaints, approximately 10% -15% felt much better than before surgery. Approximately 5% of patients showed no improvement. In any case, it is always necessary to pay attention to the work experience and qualifications of the operating surgeon: Only then can you be sure that the treatment of hallux valgus will be successful.

The specialists of our clinic have found that with the help of special exercises for the feet, the result of the operation to correct the hallux valgus is significantly improved.

What happens after Hallux valgus surgery?

  • Surgical treatment causes only minor soft tissue damage: After a short time, the patient’s physical endurance is restored.
  • Mobility of the operated joint is restored almost immediately.
  • With the help of special orthopedic shoes for correcting the forefoot, the patient can immediately step on the foot and fully load it.
  • The fixation material that was used during the osteotomy is usually not removed.In most cases, it does not have a negative effect on the foot. If the patient still feels uncomfortable, titanium screws are removed on an outpatient basis.

Rehabilitation treatment after correction of Hallux valgus

Fig. 10: After surgery, patients need to wear a special forefoot boot with a rigid sole, with which they can step on their feet immediately and become mobile. Such shoes transfer body weight to the heel.Sometimes the resulting swelling is easily eliminated by raising the leg.

Generally, the healing process takes 3 to 6 weeks. The stronger the deformity was, the longer the rehabilitation treatment will take. To obtain accurate information about the condition of the operated joint, which is necessary for the postoperative examination, an X-ray should be taken approximately 4 weeks later.

If you have been treated for hallux valgus at our clinic in Freiburg, our pediatricians will offer you a functional postoperative treatment that involves full load on the foot with a special forefoot boot that significantly reduces the risk of thrombosis.Despite this, we recommend that you still undergo thrombosis prophylaxis. Such orthopedic shoes should be worn for 2 to 6 weeks.

Postoperative / Rehabilitation

  • Special orthopedic shoes.
  • Repairing dressings.
  • Valgus splint / night brace.
  • Prevention of thrombosis.
  • Actions aimed at relieving puffiness, elevated position of the leg.
  • Actions aimed at relieving puffiness, elevated position of the leg.

Once again we draw your attention to the fact that after the operation it is necessary to keep the leg in an elevated position as often as possible: This promotes faster wound healing.

If necessary, a special valgus splint can be used at night.

After about 5 weeks, the patient is allowed to wear normal shoes again.

Postoperative treatment of hallux valgus, namely gymnastic exercises, is a necessary component in restoring muscle balance and stabilizing the foot.

If you want to speed up the healing process of the foot, we recommend that you massage the arch of the foot with a soft tennis ball. The period of incapacity for work depends on how the recovery process will take place, as well as on the patient’s profession.

Treatment of hallux valgus: Frequently asked questions

How long does it take to recover from hallux valgus surgery?

Rehabilitation treatment after surgery for hallux valgus lasts 6 weeks.However, the length of the sick leave depends on your occupation: In the case of “standing” work, you will need more time to recover than “sedentary” work.

Can I walk immediately after surgery?

By wearing a special forefoot orthopedic boot that prevents the foot from rolling over the big toe, you can walk immediately after surgery.

Is an immobilizing dressing used after surgery?

Postoperative treatment of the foot does not require the use of a plaster cast or an immobilizing bandage.The big toe remains in a passively movable position.

When can I wear normal shoes?

Even after the postoperative treatment is completed, it is recommended to wear comfortable and loose shoes for 4-6 weeks.

Bilateral Hallux valgus: Can bilateral hallux valgus be surgically treated in one day?

Our clinic offers surgical treatment of this pathology in case of emergency. If an operation of bilateral hallux valgus is necessary, it is recommended to observe an interval of three months.

Science: Science and technology:

American cardiologists have found a simple and affordable way to find out about the threat of aortic aneurysm before the critical moment – its rupture, according to The American Journal of Cardiology. This asymptomatic fatal disease kills 50 percent of patients before hospitalization, and after surgery, their survival rate is the same 50 percent.

“The biggest challenge with aneurysm is the ability to identify potential carriers of the disease in the population before the aneurysm ruptures,” said Dr. John A.Eleftheriades, senior study author and director emeritus of the Institute for Aortic Studies at Yale Hospital New Haven in Connecticut.

Cardiologists have proposed a simple thumb test for diagnosis. You need to raise your hand, as if saying to someone “Stop!”, Then stretch your thumb as far as possible towards the little finger. If the thumb protrudes beyond the edge of the palm, the researchers said it could be a sign of a latent aortic aneurysm and should be checked by a doctor.

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16:45 – December 28, 2020

00:00 – April 27

The ability to move the thumb during the test can also be a sign that bones are thinned and lengthened, and joints are weakened – possible symptoms of the disease connective tissue throughout the body, including the aorta, scientists say.

Not everyone who can move a finger during the test is at risk of an aneurysm. Dr. Eleftheriades believes that although this test is not a sufficient tool to confirm the diagnosis, it should be recommended for those with a family history of aortic aneurysm.

According to American cardiologists, aortic aneurysm overwhelmingly affects men aged 50 and older. The exact causes of the disease have not been established, but smoking definitely has a negative effect on the arteries, causing them to harden. A diet high in fat and being overweight also increases the risk of ruptured blood vessels.

The thumb test has been recommended as a method for detecting ascending aortic aneurysms, the part of a blood vessel that extends upward from the heart.However, aneurysms can occur in different parts of the aorta, including the abdominal region, which leads to the arteries in the legs.

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