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Satisfactory Functional Outcome and Significant Correlation with the Length of Haglund's Deformity after Endoscopic
Hossam Fathi Mahmoud1, Walid Feisal1, Fahmy Samir Fahmy1
1Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Insights
Endoscopic calcaneoplasty effectively treats Haglund's syndrome, improving heel pain and function. This minimally invasive surgery offers satisfactory results with minimal complications for patients with posterior heel pain.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Surgery
- Minimally Invasive Procedures
Background:
- Haglund's syndrome involves a bony prominence on the heel bone causing posterior heel pain and functional disability.
- Surgical intervention, including bone resection and bursectomy, is considered after conservative treatments fail.
Purpose of the Study:
- To evaluate the functional outcomes and patient satisfaction following endoscopic resection of Haglund's deformity.
- To assess the correlation between clinical outcomes and the size of the bony exostosis.
Main Methods:
- Seventeen patients (21 feet) underwent endoscopic calcaneoplasty.
- Clinical outcomes were assessed using the Visual Analog Scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) score.
- Preoperative and postoperative bony exostosis lengths were measured radiologically.
Main Results:
- Significant improvements were observed in AOFAS scores (55.7 to 94.3) and VAS scores (8.1 to 0.7) post-surgery (P < 0.0001).
- A significant correlation was found between clinical scores and the postoperative length of the bone.
- Patients reported high satisfaction and returned to activities with only one case of mild pain.
Conclusions:
- Endoscopic calcaneoplasty is a safe and effective minimally invasive treatment for Haglund's syndrome.
- The procedure yields satisfactory clinical results with a low complication rate at a minimum 4-year follow-up.
Background:
Haglund's syndrome is a posterosuperior calcaneal prominence with posterior heel pain causing functional disability to the patient. Operative treatment is indicated after failure of conservative measures and includes resection of the bony hump along with retrocalcaneal bursectomy. This study aimed to evaluate the functional outcome and degree of patient satisfaction after endoscopic resection of Haglund's deformity with assessment of correlation with the length of bony exostosis.
Methods:
Seventeen patients (21 feet) with a mean age of 44.7 ± 5.1 years were included in this study. Six females and 11 males underwent endoscopic calcaneoplasty. Clinical outcome evaluation included the assessment of the visual analog scale (VAS) and the American Orthopedic Foot and Ankle Society score (AOFAS). The preoperative and postoperative lengths of bony exostosis were measured radiologically. The paired t test and the Wilcoxon signed-rank test compared the preoperative and final postoperative means. P < 0.05 was considered statistically significant.
Results:
The mean follow-up period was 56.4 ± 5.1 months. Statistically significant improvements in the preoperative mean of AOFAS (from 55.7 ± 9.3 to 94.3 ± 7.1) and VAS (from 8.1 ± 1.4 to 0.7 ± 1.04) at the final follow-up were noted (P < 0.0001). There was a statistically significant correlation between clinical scores (AOFAS and VAS) and the final postoperative length of the bone above parallel pitch lines (PPLs). The patients were satisfied and returned to their previous activities without reporting major morbidities except one patient who had mild pain with exertion.
Conclusion:
Endoscopic calcaneoplasty is a safe, less invasive surgical procedure for the management of Haglund's syndrome after failure of conservative treatment. It provided a satisfactory clinical result without serious complications at a minimum 4-year follow-up.
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