Surgical correction of Haglund's triad using complete detachment and reattachment of the Achilles tendon
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Published on: January 24, 2018
J George DeVries1, Ben Summerhays, Daniel W Guehlstorf
1Wheaton Franciscan Healthcare, Wauwatosa, WI 53226, USA. skisnfeet@hotmail.com
Insights
Surgical correction of Haglund's triad, involving Achilles tendon repair and retrocalcaneal bursa/exostosis removal, significantly improves patient outcomes and satisfaction. This effective treatment offers a high success rate with minimal complications for this complex foot condition.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Surgery
Background:
- Haglund's triad is a complex condition involving Achilles tendinosis, Haglund's deformity, and retrocalcaneal bursitis.
- Simultaneous presentation of these conditions poses a surgical challenge.
Purpose of the Study:
- To evaluate the outcomes of surgical treatment for Haglund's triad.
- To assess patient satisfaction and complication rates following a specific surgical approach.
Main Methods:
- Retrospective review of 17 patients (22 feet) with Haglund's triad.
- Surgical technique included Achilles tendon detachment/reattachment, exostosis removal, and bursectomy via a medial J-shaped approach.
- Outcomes assessed using Visual Analog Scale (VAS) and Maryland Foot Score.
Main Results:
- Significant reduction in preoperative VAS (7.9) to postoperative VAS (1.6) (P < .001).
- High mean postoperative Maryland Foot Score (91.5), with 16/17 patients reporting good to excellent results.
- 16 out of 17 patients expressed satisfaction with the surgical outcome.
Conclusions:
- Surgical correction of Haglund's triad using the described medial J-approach is effective.
- The procedure leads to high patient satisfaction and functional improvement.
- This surgical method demonstrates a favorable safety profile with limited complications.
Unlabelled:
Haglund's triad consists of the simultaneous presentation of the following clinical entities: Achilles tendinosis, Haglund's deformity, and retrocalcaneal bursitis. In this retrospective study, we review outcomes following the surgical treatment of Haglund's triad by means of complete detachment and reattachment of the Achilles tendon, removal of the retrocalcaneal exostosis, and excision of the retrocalcaneal bursa through a medial J-shaped approach. Patients were identified via chart review, and sent consent forms and a questionnaire consisting of a visual analog scale (VAS), a satisfaction survey, and the Maryland Foot Score. Seventeen patients (22 feet) met the inclusion criteria and returned the consent and questionnaires. Their mean age was 51.6 +/- 11.6 years, and the mean duration of postoperative follow-up was 40.1 +/- 27.0 months. The mean preoperative VAS was 7.9 +/- 2.3, and the postoperative VAS was 1.6 +/- 1.3 (P < .001). The mean postoperative Maryland Foot Score was 91.5 +/- 9.1, with 16 good to excellent results. Of the 17 patients, 16 were satisfied and only 1 was somewhat unsatisfied. Four complications were observed, and 1 of these required further surgical intervention. The outcome of this study demonstrated that surgical correction of Haglund's triad using a medial "J" approach, complete detachment and reattachment of the Achilles tendon, exostectomy, and retrocalcaneal bursectomy provided patient satisfaction with limited complications.
Level Of Clinical Evidence:
4.
