Quintus varus: an operation that is sometimes necessary
Doctor Julien Lopez specializes in foot pathologies such as quintus varus. The operation consists of realigning the 5th metatarsus. It is performed when non-surgical solutions, such as insoles and orthopedic shoes are not enough to solve this annoying deformity.
The forefoot is made up of 5 metatarsals extended by several phalanges. These are the bones that hold your foot and allow you to lean on it and thus, to walk. When one of the metatarsals is affected by a deformation or inflammation, discomfort is caused resulting in pain and difficulty in movement.
The pathology of the forefoot "Quintus varus" is the name given to the misalignment of the fifth metatarsus, that of the smallest toe. This pathology causes the associated joint to tilt, creating a bump on the lateral part of the foot. Also called "bunionette" or "tailor's bunion", this deformation creates inflammation due to the friction of this malformation in the shoe.
Being able to also make the little toe deviate towards the 4th, this pathology can cause a supra-adductus or an infra-adductus. These terms mean that the fifth metatarsus will pass over or under the 4th toe. Just like the bilateral hallux valgus, with a quintus varus the joint is off axis. How to avoid this pathology of the foot which can be disabling on a daily basis? How to treat it without surgery? How is the operation carried out and when it is necessary? Doctor Julien Lopez performs this surgical procedure so that you can walk again without pain and discomfort on a daily basis.
Digitus quintus varus: risk factors and consequences
Several factors can cause digitus quintus varus, causing daily discomfort as soon as you walk.
The causes of fifth ray angulation and quintus varus are multiple, but the occurrence of these foot pathologies is essentially hereditary.
The occurrence of this deformation can be caused independently of your will:
- A birth defect
- Inflammatory diseases affecting the joints
- Consequences of a stroke
- Surgical operations performed on other toes or on flat feet.
However, certain risk factors can be minimized or controlled in order to avoid too much rubbing of your little toe in your shoes. Thus, the development of a quintus varus can be avoided. Located at the front of the foot, this deformation of the 5th metatarsal may be due to a choice of shoes unsuited to your plantar health.
Here are the characteristics of the latter that it is better to avoid, in order to prevent this pathology:
- High heels with pointed toes, crushing and bringing the little toe inwards
- Very rigid but also too flexible shoes, such as moccasins or ballet flats
We also advise you to avoid walking with completely barefoot and to maintain a stable weight, so as not to increase the pressure and stress on your forefoot.
The consequences of quintus varus
The quintus varus admits several disabling consequences in the realization of movements and on your self-confidence.
The physical consequences are as follows:
- Consequent pain due to friction between the toe and the shoe
- Soft corns forming between the two affected toes, due to friction and their increasing proximity
- Sores or inflammation of the phalanx, which also cause pain
- The longer you wait to treat this pathology, the greater the deviation of your toe will be.
Some consequences can also materialize psychologically because of the physical difficulties caused by your quintus varus:
- Daily discomfort because the foot is the point of contact between the human body and the ground at all times of your day
- A certain lack of self-confidence in situations where you have to go barefoot
- Social difficulties, a feeling of discomfort during the summer and difficulties in choosing your shoes
Knowing the negative elements caused by this deformation of the 5th metatarsus, we are going to give you elements that will allow you to visualize the different possible actions, so that you can better live with it and make it disappear.
Treat a quintus varus of the little toe, without surgery
How to treat quintus varus of the little toe without surgery? Several alternatives are available to you in order to reduce the pain and pressure on your little toe, injured by this deformation.
First, orthopedic insoles molded to the shape of your foot are designed by placing your foot in a “borrower”. This dedicated and specialized device in the production of soles allows the molding of your foot print in a thermo-molded resin. Thus, the sole produced will be totally adapted to your sole and the shape of your foot.
It reduces friction and offers support to your currently deformed metastasis, without the need to perform a quintus varus osteotomy.
Orthopedic shoes can also be considered to avoid the various pains caused by this quintus varus.
The choice must be made carefully, according to these criteria:
- Good stability and optimal height to avoid slipping when the primary goal is to keep it in a certain position
- A tip of a certain width to avoid too much pressure and leave room for your toes
- Without seams in the internal part of the shoe to avoid additional friction
- Insoles that can be removed and outer soles of sufficient thickness to avoid shocks and maintain foot stability
Orthoplasty can also be considered. This technique is tailor-made for each patient and avoids various frictions. Molds placed in the intervals between each toe, means that the friction between them and the shoe is then reduced. Pain is therefore reduced thanks to the adaptation of the position of the 5th metatarsus.
When this technique does not work, surgery should be considered. The price of the quintus varus operation varies from one clinic and from one professional to another. Doctor Julien Lopez performs surgery at affordable prices in Nice, Mandelieu and Cap d'Ail. Orthoplasty can also be considered. This technique is tailor-made for each patient and avoids various frictions. In the form of molds placed in the intervals between each toe, the friction between them and with the shoe is then reduced. Pain is thus reduced thanks to the adaptation of the position of the 5th metatarsus.
When Quintus varus orthoplasty is not enough: surgery is necessary
When insoles, shoes and quintus varus orthoplasty are not enough, surgery should be considered.
The surgeon performing the operation should have a certain expertise and level of experience. If the surgery is performed incorrectly, complications could arise.
What does this foot and quintus varus surgery involve? The aim is to realign the deformed metatarsus by bringing its upper part towards the 4th toe.
What is the exact procedure for this quintus varus arthroplasty? Either the surgery is performed open or percutaneous.
Open air involves :
- Lengthening of the currently retracted 5th metatarsal
- Risks of recurrence
Percutaneous, which is easier to perform for the surgeon involves:
- Retracting tendons of the retracted using a miniaturized scalpel
- An osteotomy of the phalanx and/or metatarsal bone
It straightens the little toe and relaxes the soft parts surrounding it.
What are the objectives of this minimally invasive quintus varus surgery operation?
- Removal of pain
- Rebalancing your supports
This surgical operation has certain limited risks:
- Infections from the incisions
- Healing can be long, especially in people who smoke
- Quintus varus surgery and phlebitis are also linked
- The presence of hematomas is frequent but their disappearance is rapid
- Stiffness in the toes may also occur
- Less sensitivity in your foot
- Edema can also appear
In order to mitigate these undesirable effects, wearing compression stockings, daily walking and keeping your leg elevated can be helpful.
As this surgery is carried out over a short period of time, the goal is that there is a rapid recovery, that walking is easier and your daily life is more comfortable and without pain. Doctor Julien Lopez provides complete support from your first consultation to the quintus varus operation and a quality post-operative follow-up. Consultations are based in Nice, Cap d'Ail and Mandelieu.