Haglund's syndrome

• Published in: The Journal of foot and ankle surgery Vol. 37; no. 2; pp. 110 - 114
• Main Authors: Sella, Enzo J., Caminear, David S., McLarney, Elizabeth A.
• Format: Journal Article
• Language: English
• Published: Baltimore, MD Elsevier Inc 01.03.1998; Data Trace
• Subjects: Achilles Tendon; Adolescent; Adult; Biological and medical sciences; Bursitis - complications; Bursitis - surgery; Calcaneus - diagnostic imaging; Calcaneus - surgery; exostosis; Female; Foot Deformities - complications; Foot Deformities - surgery; Haglund's deformity; heel pain; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Osteoarticular system. Muscles; Osteotomy - methods; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiography; retrocalcaneal bursitis; Syndrome; Tendinopathy - complications; tendonitis; Haglund's deformity; heel pain; tendonitis; retrocalcaneal bursitis; exostosis; Juxtaarticular disease; Human; Radiodiagnosis; Osteotomy; Tendo calcaneus; Diseases of the osteoarticular system; Lower limb; Exploration; Calcaneum; Result; Ankle; Radiography; Angular measurement; Orthopedic surgery; Tendinitis; Disease of the foot; Preoperative; Technique; Bursitis; Predictive factor
• ISSN: 1067-2516; 1542-2224
• DOI: 10.1016/S1067-2516(98)80089-6

Haglund's syndrome is a painful condition of the heel caused by mechanically induced inflammation of the retrocalcaneal bursa, supracalcaneal bursa, and Achilles tendon. Surgical management has included calcaneal osteotomy, but results have been unpredictable because of the inability to measure accurately bone removal. A method was devised in this study to accurately determine radiographically the amount of bone removal necessary. Sixteen heels in 13 patients underwent surgery after failing 21 months of conservative treatment. The desired osteotomy angle (preop x-rays) was compared to the actual angle obtained at surgery. A patient questionnaire, developed by the Outcome Study Committee of the AOFAS, was used to assess results. There were 13 good results and 3 failures. The average actual angle of the good results was 49° and that of the poor results was 61°. These results were statistically significant to a p = .0012. The average score obtained by the good results was 87 points, while that of the failures was 25 points. Follow-up was 42 months. The authors recommend that the osteotomy be made in such a way as to remove not only the superolateral deformity, but also to decompress the retrocalcaneal bursa and to remove the calcaneal step. In order to do so, an osteotomy angle of 49 degrees should be achieved.