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      Surgical Management of Haglund's Syndrome in Nonathletes: A Retrospective Review

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          ABSTRACT

          Aim

          The present study was carried to retrospectively analyze the outcomes of patients with Haglund's syndrome treated with author's preferred technique and to compare and validate its results by comparing with the available literature.

          Materials and methods

          Twenty-four patients who had undergone surgery for Haglund's syndrome between 2008 and 2014 were identified retrospectively from records and included in the study cohort. Visual analog scale (VAS) score and American Orthopedic Foot and Ankle Score (AOFAS) were computed preoperatively and at each follow-up, the records of which were available through patient notes. The mean follow-up period was 32 months (12—55 months).

          Results

          The VAS score improved from a mean of 6.9 to 0.5 at 6 weeks follow-up and to 0.12 at 12 weeks follow-up. The mean AOFAS increased from 55.54 ± 7.26 to 91.20 ± 6.84 at 12 weeks follow-up. None of the patients had any significant complications. At 1 year follow-up, all the patients had returned to their predisease activity level.

          Conclusion

          Open surgical management with an individualized approach provides good to excellent outcomes with minimal complication rates.

          How to cite this article

          Agarwala S, Agrawal P, Sobti AS. Surgical Management of Haglund's Syndrome in Nonathletes: A Retrospective Review. J Foot Ankle Surg (Asia-Pacific) 2017;4(1):19-22.

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          Most cited references13

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          Long-term clinical outcomes following the central incision technique for insertional Achilles tendinopathy.

          The central incision technique, more than any other exposure, allows for optimal access to the diseased Achilles tendon as well as the Haglund's prominence and the retro calcaneal bursa. We hypothesized that the central incision technique would be an effective, well-tolerated surgical incision for the surgical treatment of insertional Achilles tendinopathy with minimal to no loss of plantarflexion strength.
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            Surgical strategies: insertional achilles tendinopathy.

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              Diagnostic significance of radiologic measurements in posterior heel pain.

              Posterior heel pain is a common complaint in both athlete and non-athlete. For diagnosis of etiology certain angles, lines and soft tissue parameters have been developed in the literature to describe the calcaneal prominence and its relationship to Achilles tendon and its bursae. A prospective study was undertaken to evaluate the diagnostic values of these angles, lines and soft tissue parameters in posterior heel pain. Seventy-one painful heels in 58 patients (30 males and 28 females, mean+/-S.D. age; 41.4+/-10.82 years) were clinically and radiologically examined. This was compared with 50 heels in 25 control subjects. A lateral weight bearing film of the foot was taken to calculate different angles, lines and soft tissue parameters mentioned in the literature. There were 45 Pavlov's parallel pitch line positives and using test of Denis and Huber-Levernieux in only one posterior superior crest extended beyond vertical tangential. There was only one heel with Fowler & Philip angle >75 degrees. There were 10 heels with Steffensen & Evensen angle >65, 5 heels with total angle >90 degrees and 52 heels with Chauveaux-Liet angle >12 degrees. There were 73% true positive for Chauveaux-Liet angle and 63% true positive for parallel pitch line. Among soft tissue parameters ill defined retrocalcaneal recess was present in 61 symptomatic heels, plantar spur in 42 heels, posterior calcaneal step in 33 heels, Achilles tendon calcification in 29 heels, superficial tendo-Achilles bursitis in 58 heels, posterior calcaneal spur in 31 heels and antero posterior diameter of tendo-Achilles more than 9 mm in 68 symptomatic heels. Parallel pitch lines, Chauveaux-Liet angle, ill-defined retrocalcaneal recess, superficial tendo-Achilles bursa and anteroposterior diameter of Achilles tendon more than 9 mm about 2 cm above insertion are reliable objective diagnostic indicators of bony deformity of calcaneus and soft tissue affection in patients with posterior heel pain. It is the combination of these bony and soft tissue parameters, which enhance the diagnostic certitude.
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                Author and article information

                Contributors
                Role: Head, Director, and Consultant
                Role: Clinical Fellow
                Role: Clinical Fellow
                Journal
                JFASAP
                Journal of Foot and Ankle Surgery (Asia Pacific)
                JFASAP
                Jaypee Brothers Medical Publishers
                2348-280X
                2394-7705
                January-June 2017
                : 4
                : 1
                : 19-22
                Affiliations
                [1 ]Department of Orthopaedics, P.D. Hinduja Hospital & Medical Research Centre, Mumbai, Maharashtra, India
                [2 ]Department of Orthopaedics, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, Greater Manchester, UK
                [3 ]Department of Orthopaedics, County Durham and Darlington NHS Trust, Darlington Memorial Hospital, Darlington, Durham, UK
                Author notes
                Sanjay Agarwala, Head, Director, and Consultant, Department of Orthopaedics, P.D. Hinduja Hospital & Medical Research Centre, Mumbai, Maharashtra, India, e-mail: drsa2011@ 123456gmail.com
                Article
                10.5005/jp-journals-10040-1064
                8c1ed0ac-7284-435f-aae8-bdea6c4e12bd
                Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.

                Creative Commons Attribution 4.0

                History
                Categories
                ORIGINAL ARTICLE
                Custom metadata
                jfasap-2017-4-19.pdf

                General medicine,Pathology,Surgery,Sports medicine,Anatomy & Physiology,Orthopedics
                Achilles tendinopathy,Heel pain,Haglund's

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