Higher BMI Is Associated With Wound Breakdown Following Resection of Haglund Deformity

Area of Science:

• Orthopedic surgery
• Podiatric surgery
• Obesity medicine

Background:

• Haglund deformity involves an enlarged calcaneus, potentially causing bursitis and Achilles tendinitis.
• Obesity is a growing concern in orthopedic patient populations.

Purpose of the Study:

• To investigate the association between obesity and postoperative complications following Haglund deformity resection.
• To analyze complication rates across different body mass index (BMI) categories.

Main Methods:

• Retrospective review of 370 patients undergoing Haglund resection (2015-2023).
• Patients stratified by BMI: normal (<25), overweight (25-29.9), and obese (≥30).
• Obese patients further classified into Class I, II, and III based on BMI.

Main Results:

• Obese patients (73.8%) had significantly higher wound breakdown rates (11.0%) compared to overweight (2.6%) and normal (0.0%) groups (P=.02).
• Obese cohort showed higher prevalence of females, Black/African American race, diabetes, and higher ASA scores.
• No significant differences in complications were found between obesity subclasses.

Conclusions:

• Obesity is a significant risk factor for complications, particularly wound breakdown, after Haglund resection.
• Perioperative optimization and careful patient selection are essential for managing obese patients undergoing this procedure.