Results of Surgical Treatment of Haglund’s Desease

The objective of the study — to propose a classification for Haglund’s syndrome based on the differentiated treatment outcomes and to conduct a systematic review of articles on this topic.Materials and Methods. The article based on the diagnosis and treatment of 77 patients with Haglund’s syndrome. 68 patients with Haglund’s syndrome underwent surgery (79 operations), 14 of which were endoscopic. In 9 patients conservative treatment techniques were undertaken.Results. As a result of analyzing a variety of cases of Haglund’s syndrome, we proposed clinical and morphological classifications for Haglund’s syndrome that help to choose the optimal treatment tactics. according to its clinical form, Haglund’s deformity may be common, atypical, and “hiding”. A special clinical variation is a cosmetic form. Depending on morphological characteristics, it was proposed to distinguish upper, upper-lateral, “arc type”, total types, and atypical variations. With the upper type of deformity and, rarely, with the upper-lateral one, an endoscopic technique or minimally invasive surgical correction is preferable. For more extensive variants, the only solution should be an open procedure. The outcomes at 11.5±1.2 months after surgery showed significant improvement in patient condition as compared to the preoperative status (p<0.001). On the AOFAS, the scores were 92.2±3.1 after open procedures (86.1±3.5 and 93.2±2.2 for the different types) and 94.7±1.8 after endoscopic operations. However, we cannot speak confidently of the advantage of endoscopic surgery, since adequate resection during the endoscopic operation is possible only in limited cases of the Haglund’s deformity types (upper and upper-lateral). For the same reason, it is impossible to compare the results of minimally invasive surgery with fluoroscopic control with the results of open surgical intervention. according to AOFAS (p<0.001), conservative treatment also improved the status of patients, more specifically from 75.1±4.7 to 80.1±5.7. However these improvements were significantly less compared to surgical treatment (p<0.001). Our results of patient treatment were included in an updated systematic review of twenty-eight studies related to the results of open (681 patients in total) and endoscopic (321 patients in total) treatment of patients with Haglund’s syndrome.Conclusion. Particular attention should be paid to the “hiding” clinical cases which do not manifest signs of tenopathy, but are detrimental to athletic performance. We consider treatment strategy based on clinical and morphological classifications as justified, when the type of operation (open, minimally invasive or endoscopic) was determined by the type of deformity and its localization.

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Classification for Haglund’s Syndrome (Deformity)

Середа

Белякова

2019

Traumatology and Orthopedics of Russia

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Problems of semiotics of diseases of the Achilles tendon in clinical and educational aspects

Sorokin

Середа

Konovalchuk

et al. 2022

jour

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Achilles tendon disorders are represented by a big group of heterogenous in etiology and pathogenesis conditions, that are quite frequent in patients of various age groups. The diversity of this group of orthopedic disorders and the insufficient information provided on this topic in specialized literature leads to confusion in terminology, which, in turn, leads to misunderstanding the essence of patient’s problem and to mistakes in treatment of such patients.We carried out a content-analysis of contemporary Russian and foreign literature to summarize the existing knowledge and to create the universal nomenclature of the studied pathological conditions for further correct understanding of the problem and creation of classification of disorders and injuries of Achilles tendon.

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Results of Surgical Treatment of Haglund’s Desease

Cited by 2 publications

References 12 publications

Classification for Haglund’s Syndrome (Deformity)

Classification for Haglund’s Syndrome (Deformity)

Problems of semiotics of diseases of the Achilles tendon in clinical and educational aspects

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