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Definition

 Haglund’s deformity is a prominence on the superior aspect of the calcaneus.

 Usually developmental in origin, but may be related to chronic apophysitis in childhood.

Physical eximination

  • Prominence and tenderness at superolateral margin of calcaneal tuberosity

  • Swelling may be present in the retrocalcaneal bursa.

  • Note tenderness or nodularity along the course of the Achilles tendon.

  • decreased dorsiflexion with Achilles disorders

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Treatment

conservative treatment : The goal is to decrease friction between the heel counter and inflamed bursa; this includes shoe wear modifications (a heel wedge to lift the heel from the shoe and alter the contact pattern), ICE therapy, shock wave

Corticosteroid injections in and around the Achilles tendon are contraindicated due to an increased risk of rupture.

Surgical interventions typically involve removal of the excess bone on the superior margin of the calcaneal tuberosity (open or arthroscopy), along with débridement of bursal tissue and any diseased areas of the Achil­les tendon itself.

In insertionnal Achilles tendonitis, the latter could be detached, allowing to remove the bone spur and the inflammated tendon fibers. At the end of the surgery, achilles tendon is re-attached.

 

Complications

Surgical intervention is at risk of the following complications

  • Achilles tendon avulsion

  • Persistent post heel pain

  • Wound breakdown

  • Sural nerve injury

  • Ankle stiffness

  • Incisional neuroma

This information is a brief, simple medical explanation. For exhaustive details, and before starting any kind of treatment, please refer to Dr.BAYOUD