Surgical Treatment of Insertional Achilles Tendinosis and Haglunds Deformity by Using Central Tendon-splitting Approach: Retrospective Case Series of 15 Cases

Dave, Malhar; Dave, Heloni M; Rathava, Rakesh; Moradiya, Niravkumar

doi:10.5005/jp-journals-10040-1099

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…Haglund’s deformity is a common cause of posterior heel pain, characterized clinically by prominent bursal bony projection. Dorsiflexion between the Achilles tendon and the calcaneal tuberosity results in bursal inflammation secondary to impingement or mechanical irritation [ 2 ]. Presenting complaints include pain at the posterior aspect of the heel which usually is triggered when the patient begins to walk after a period of rest or inactivity.…”

Section: Introductionmentioning

confidence: 99%

Heel Pain Management in Haglund’s Deformity Targeting Sural Nerve Branches under Ultrasound Guidance: Case Report

Lotliker,

Verma,

Bhalla

et al. 2024

jocr

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Introduction: Haglund’s deformity is an abnormality of the bone and soft tissue of the foot, also known as retrocalcaneal exostosis, Mulholland deformity, and “pump bump”. The etiology is not well known. Probable causes include a tight Achilles tendon, a high arch of the foot, and hereditary. The clinical features consist of pain at the posterior aspect of the heel which is predominantly present when the patient begins to walk after a period of rest or inactivity. Case Report: We report a case of a 60-year-old teacher with left heel pain for 3 years, unable to stand or walk for more than 15 min due to pain. We diagnosed him as a case of Haglund’s deformity and treated him with ultrasound-guided injections targeting the superficial branches of the sural nerve. This case report illustrates a rarely described modality for the management of heel pain due to Haglund’s deformity. Targeting superficial branches of the Sural nerve under ultrasound guidance can act as a superior treatment modality for the management of heel pain due to Haglund’s deformity. Conclusion: Haglund's deformity is a cause of pain in the hindfoot that should be taken into account in the differential diagnosis of any patient presenting with heel pain. Ultrasonography has proved to be an important cost-effective tool in the diagnosis and management of various ankle pathologies like Haglund’s deformity, thereby reducing the sole dependence on surgical management. Targeting the superficial (cutaneous) branches of the sural nerve can give satisfactory long-term relief of heel pain in patients with Haglund deformity. Keywords: Haglund’s deformity, heel pain, ultrasound-guided injection, sural nerve, rehabilitation.

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Section: Introductionmentioning

confidence: 99%

Heel Pain Management in Haglund’s Deformity Targeting Sural Nerve Branches under Ultrasound Guidance: Case Report

Lotliker,

Verma,

Bhalla

et al. 2024

jocr

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“…It also affects middle aged persons due to the degenerative processes being initiated by this time. 2 The pain can be described as dull aching type onset more commonly seen when the patient starts activity or walking after prolonged rest or inactivity. Diagnosis is usually based on taking an elaborate history, clinical examination and imaging studies.…”

Section: Introductionmentioning

confidence: 99%

Functional outcome of operative management of Haglund deformity in non-athletic individuals-a case series

Supe,

Singh,

Pawar

et al. 2024

Int J Res Orthop

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Haglund’s deformity is a symptomatic osseous outgrowth or prominence of the posterolateral corner of calcaneus usually in young individuals which presents in the form of posterior heel pain, sometimes intractable in chronic cases, which aggravates on walking or on dorsiflexion of the foot and is relieved with rest and anti-inflammatory medications in the initial phases. Management involves an initial conservative trial involving lifestyle changes and medical management, failure of which warrants surgical management for symptomatic relief along with ability to return to perform activities of daily living. We have a series of 4 patients with a Haglund’s deformity who presented to us with chronic posterior heel pain of varying duration with episodic exacerbations who were initially managed with a conservative trial with medications, physiotherapy, lifestyle modifications, usage of soft silicon sole for the footwear; the failure of which prompted us to go ahead with surgical management of these patients-all 4 patients were managed with a lateral wedge removal of the calcaneus with excision of the retrocalcaneal bursa. All 4 patients reported significant improvement in the symptoms with adequate postoperative care and rehabilitation. As we have seen in this case series of 4 patients presented here, Haglund’s deformity which is a part of a larger Haglund’s syndrome, has a chronic progression over a period of time with episodic exacerbations and remissions, which could be managed conservatively for a significant period initially but, if need be, surgical management should not be deferred not only to provide symptomatic relief as a major goal, but also to avoid permanent degenerative damages to the concerned soft tissues.

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Surgical treatment of Hagelund deformity by lateral approach: Case report

Kumar,

Pasricha,

Agarwal

et al. 2023

JBJD

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Haglund deformity is a common presentation in patients with chronic posterior heel pain with a long duration of symptoms. In this case report, we have managed this deformity by mini-open approach and, thereby, compared it to other approaches. In this case, we have taken a patient who had chronic posterior heel pain for 1 year and was managed by conservative methods but was not satisfied; therefore, after thorough evaluation including radiographs and blood investigations, the decision of surgical intervention was taken to remove the posterosuperior bump on the calcaneum in by a mini-open lateral approach. He had a current American orthopedic foot and ankle score (AOFAS) score of 65 before the surgery. The AOFAS score improved from 65 points presurgery to 88 points at 1-week follow-up postsurgery and increased to 94 points at 2-week follow-up. The lateral approach to Haglund syndrome is better than other approaches whenever there is sparing of the Achilles tendon in terms of degeneration or split. As this approach is done by mini-open; there is a significant improvement in AOFAS points in a short duration; the method is cost-effective; and the patient is able to walk from the next day. Further, the Achilles tendon does not require splitting or postoperative immobilization.

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Surgical Treatment of Insertional Achilles Tendinosis and Haglunds Deformity by Using Central Tendon-splitting Approach: Retrospective Case Series of 15 Cases

Cited by 3 publications

References 22 publications

Heel Pain Management in Haglund’s Deformity Targeting Sural Nerve Branches under Ultrasound Guidance: Case Report

Heel Pain Management in Haglund’s Deformity Targeting Sural Nerve Branches under Ultrasound Guidance: Case Report

Functional outcome of operative management of Haglund deformity in non-athletic individuals-a case series

Surgical treatment of Hagelund deformity by lateral approach: Case report

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