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Published on: January 23, 2018
[Advance of diagnosis and treatment of Haglund syndrome]
Jie Wang1, Xiantie Zeng1, Xinlong Ma2
1Department of Orthopaedics, Tianjin Hospital, Tianjin, 300211, P.R.China.
Insights
Haglund syndrome diagnosis and treatment involve understanding its complex anatomy and potential genetic links. Both surgical and conservative methods are effective, with minimally invasive techniques showing promise for heel pain management.
Area of Science:
- Orthopedics
- Sports Medicine
- Podiatry
Background:
- Haglund syndrome, a condition affecting the posterior heel, involves complex local anatomy and potential genetic factors.
- It is characterized by impingement of the posterior heel bursa and Achilles tendon insertion, leading to pain and wear.
Purpose of the Study:
- To review current research on the diagnosis and treatment of Haglund syndrome.
- To analyze the etiology, anatomy, clinical manifestations, diagnosis, and treatment of Haglund syndrome.
Main Methods:
- Extensive review of domestic and foreign literature on Haglund syndrome.
- Analysis of diagnostic measurements including Fowler-Philipp angle (FPA), calcaneal pith angle (CPA), parallel pitch lines (PPL), Chauveaux-Liet angle (CLA), and X/Y ratios.
Main Results:
- Etiology is unclear, possibly linked to friction, muscle tension, and genetics.
- Radiographic measurements (FPA, CPA, PPL, CLA, X/Y ratios) aid in diagnosing Haglund malformation.
- Treatment options include conservative management and surgical interventions like Haglund ostectomy and calcaneal osteotomy.
Conclusions:
- Open and arthroscopic Haglund ostectomy and calcaneal osteotomy yield satisfactory outcomes.
- Minimally invasive treatments represent the current trend in managing Haglund syndrome.
- Attention to Achilles tendon insertion calcification and reconstruction is crucial.
Objective:
To review the current research on the diagnosis and treatment of Haglund syndrome.
Methods:
The domestic and foreign literature about Haglund syndrome in recent years was extensively reviewed to summarize and analyze the etiology, anatomy, clinical manifestations, diagnosis, and treatment of Haglund syndrome.
Results:
The etiology of Haglund syndrome is not very clear, and it may be related to local friction and high gastrocnemius muscle tension, and there may be a certain genetic tendency. The local anatomy is more complex and there are many adjacent tissue structures. Haglund malformation may cause the impingement of the posterior heel bursa and Achilles tendon insertion, lead to wear of the posterior heel bursa and the Achilles tendon insertion, and finally result in pain. The FPA (Fowler-Philipp angle), CPA (calcaneal pith angle), PPL (parallel pitch lines), CLA (Chauveaux-Liet angle), and X/Y ratios (ratio of total calcaneal length to calcaneal tuberosity length) measured on X-ray film can be used for the diagnostic measurement of Haglund malformation. Treatment includes conservative and surgical treatment (open Haglund ostectomy, dorsal closed wedge osteotomy of the calcaneus, and arthroscopic Haglund osteotomy).
Conclusion:
Both open and arthroscopic Haglund ostectomy and dorsal closed wedge osteotomy of the calcaneus can achieve satisfactory results, but minimally invasive treatment is the current development trend. Surgeons should pay attention to the management of the calcification of Achilles tendon insertion and reconstruction of Achilles tendon insertion.
