Related Experiment Video
Updated: May 5, 2026
Predictive Measurement for Windlass Change in Length and Selected Treatment Outcomes in Chronic Plantar Fasciitis
Published on: March 1, 2024
Comparison of Dorsal Closing Wedge Calcaneal Osteotomy and Exostectomy With Tendon Repair for Insertional Achilles
Moheib Ahmed1, Ahmed El-Hawary1, Amr Elshahhat1
1Mansoura University, Mansoura, Egypt.
Background:
The optimal surgical approach for mild-to-moderate insertional Achilles tendinopathy (IAT) with Haglund deformity remains controversial. This study compares the clinical and radiological outcomes of Zadek Calcaneal Closing Wedge Osteotomy (ZCCWO) and Calcaneal Exostectomy with Tendon Repair (CE-TR).
Material And Methods:
This retrospective study included 30 patients (15 ZCCWO, 15 CE-TR) with mild-to-moderate IAT associated with calcaneal exostosis. Clinical outcomes were assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Score and Numeric Pain Rating Scale (NPRS). Radiological evaluations included the Fowler-Phillip (FP), Calcaneal Pitch (CP), and Chaveaux-Liet (CL) angles. The mean follow-up was 39 ± 8.8 months (ZCCWO) and 31.4 ± 5 months (CE-TR).
Results:
Both groups demonstrated significant improvements in AOFAS and NPRS scores (P < .00001) with no statistically significant differences between them (AOFAS: P = .6, NPRS: P = .65). The postoperative decline in FP angle was comparable (ZCCWO: 10.1°±3.9°, CE-TR: 9.7°±4.4°; P > .05). Non-union occurred in 1 ZCCWO case (6.6%), while superficial wound infections were more common in the CE-TR group (13.3% vs 6.6%).
Conclusion:
The ZCCWO and CE-TR provide equivalent functional and radiological outcomes for mild-to-moderate IAT associated with Haglund deformity. Both procedures are effective and safe, with complication profiles that warrant consideration in surgical planning.
Level Of Evidence:
level IIIClinical trial registration:Not applicable.
Related Concept Videos
01:22Burn Injuries
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History: