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Surgical Correction of Haglund's Triad Using a Central Tendon-Splitting Approach: A Retrospective Outcomes Study
Zhan Xia1, Andy Khye Soon Yew2, Ting Karen Zhang3
1Orthopaedic Resident, Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
Insights
This study shows that a specific surgical approach for Haglund
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Surgery
- Musculoskeletal Disorders
Background:
- Haglund's triad, a condition involving Haglund's deformity, retrocalcaneal bursitis, and Achilles tendinopathy, often requires surgical intervention.
- Traditional surgical methods may involve various approaches with differing outcomes and complication rates.
- Evaluating minimally invasive or tendon-sparing techniques is crucial for improving patient recovery and satisfaction.
Purpose of the Study:
- To assess the surgical outcomes of Haglund's triad using a central tendon-splitting approach.
- To evaluate pain reduction, functional improvement, and patient satisfaction following the surgical procedure.
- To identify potential risk factors influencing surgical success.
Main Methods:
- Retrospective review of 22 patients (22 heels) who underwent surgery for Haglund's triad between January 2010 and December 2015.
- Surgical technique involved a central tendon-splitting approach with Achilles tendon debridement, bursa excision, Haglund's prominence resection, and tendon reattachment.
- Data collected included visual analog scale (VAS) pain scores, American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scores, SF-36 health survey scores, and patient satisfaction.
Main Results:
- Significant improvements were observed in VAS pain scores, AOFAS Ankle-Hindfoot scores, and SF-36 physical component scores.
- The overall patient satisfaction rate was 77.3% (17 out of 22 patients).
- Postoperative complications included delayed wound healing (2 cases) and transient sensation loss (1 case); no Achilles tendon ruptures or infections occurred. Gender and BMI did not impact outcomes.
Conclusions:
- The central tendon-splitting surgical approach for Haglund's triad effectively alleviates pain and enhances foot and ankle function.
- This surgical technique leads to overall improvement in patients' health-related quality of life.
- Further research is warranted to explore long-term outcomes and identify specific risk factors associated with this surgical method.
Abstract:
We evaluated the surgical outcomes of Haglund's triad using a central tendon-splitting approach, with Achilles tendon partial detachment and debridement, excision of the retrocalcaneal bursa, resection of Haglund's prominence, and reattachment of the Achilles tendon. The medical records of 22 patients (22 heels) who had undergone surgical correction of Haglund's triad from January 2010 to December 2015 were reviewed retrospectively. The visual analog scale pain score, American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale score, and 36-item Short-Form Health Survey physical and mental component scores were prospectively collected preoperatively, 6 months postoperatively, and at the last visit. The scores of a subjective question involving satisfaction were prospectively collected at the last visit. Possible risk factors were also evaluated. We reviewed the data from 12 females and 10 males, with the mean age of 59.2 ± 7.3 years and a mean follow-up duration of 15.1 ± 4.6 months. Significant improvement was found in the mean visual analog scale pain score, average American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale score, and 36-item Short-Form Health Survey physical component scale score. The overall satisfaction rate was 77.3% (17 of 22). Postoperative complications included 2 cases of delayed wound healing and 1 case of sensation loss over the heel wound. No Achilles tendon rupture or wound infection developed. Gender and body mass index did not affect the surgical outcomes. The surgical technique we used for Haglund's triad provided effective pain relief, function improvement, and overall enhancement of patients' health condition. More research is required to further evaluate the outcomes of our surgical approach to treat Haglund's triad and the possible risk factors.
