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Functional Outcomes Following Partial Osteotomy of the Calcaneal Tuberosity for Haglund's Syndrome
Saran Karthik S1, Pradeep Elangovan2, Akshaya Sekar3
1Orthopedics, All India Institute of Medical Sciences Madurai, Madurai, IND.
Insights
Surgical calcaneal tuberosity osteotomy effectively treats Haglund's syndrome, improving heel pain and function. This procedure offers significant functional gains for patients unresponsive to conservative care.
Area of Science:
- Orthopedic Surgery
- Podiatric Medicine
- Musculoskeletal Conditions
Background:
- Haglund's syndrome causes posterior heel pain due to soft tissue swelling and calcaneal prominence.
- Conservative treatments often fail, necessitating surgical intervention for persistent heel pain.
Purpose of the Study:
- To evaluate functional outcomes after oblique partial excision (calcaneal tuberosity osteotomy) for Haglund's syndrome.
- To assess the efficacy of surgical intervention when conservative management is ineffective.
Main Methods:
- A cohort of 30 adult patients with refractory Haglund's syndrome underwent calcaneal tuberosity osteotomy.
- Patients were assessed pre-operatively and post-operatively using the American Orthopedic Foot and Ankle Society (AOFAS) score.
- Data were analyzed using descriptive statistics and the Friedman test.
Main Results:
- The mean AOFAS score significantly improved from 55.17 pre-operatively to 79.27 at six months post-operatively (p < 0.001).
- Over 50% of patients achieved good functional outcomes (AOFAS 80-89) by six months.
- Both medial and lateral surgical approaches demonstrated comparable efficacy.
Conclusions:
- Partial calcaneal tuberosity osteotomy is a safe and effective surgical treatment for Haglund's syndrome.
- The procedure leads to significant improvements in patient function and heel pain.
- AOFAS scoring reliably quantifies the positive outcomes of this surgical intervention.
Abstract:
Background Haglund's syndrome, a common cause of pain in the posterior heel that consists of painful swelling of the local soft tissues and prominence of the posterosuperior calcaneal projection, presents significant challenges in treatment, particularly when conservative management fails. This study evaluates the functional outcomes following oblique partial excision of the posterosuperior portion (calcaneal tuberosity osteotomy) of the calcaneus for Haglund's syndrome. Methods A cohort of 30 patients, aged 18 years and older, with persistent heel pain unresponsive to conservative treatments, underwent partial osteotomy using a medial or lateral approach. Patients were assessed pre-operatively and post-operatively at six weeks, three months, and six months using the American Orthopedic Foot and Ankle Society (AOFAS) scoring system. Data were analyzed using descriptive statistics and the Friedman test to evaluate changes in AOFAS scores over time. Results The mean AOFAS score improved significantly from 55.17 pre-operatively to 79.27 at six months post-operatively. At six months, 16 (53.3%) participants had AOFAS scores between 80-89, indicating good functional outcomes, while 14 (46.7%) had scores between 70-79. The improvement in functional outcomes was statistically significant (p < 0.001). The study also found both lateral and medial surgical approaches yielded similar results. Conclusion Partial osteotomy of the calcaneal tuberosity is a safe and effective surgical intervention for Haglund's syndrome, leading to significant functional improvements. The use of AOFAS scoring provides a reliable assessment of outcomes, confirming the procedure's efficacy.
