最小侵襲ハグランド切除術におけるアキレス腱損傷の死体解剖学的評価

Insertional Achilles tendinopathy is an extremely common pathology to all foot and ankle surgeons. The relationship between calcaneal morphology and the Achilles has been recognized since its original description by Swedish orthopedist Dr Haglund in 1928. Minimal invasive surgery (MIS) often allows for smaller incisions, optimal skin healing, and maintenance of the Achilles tendon insertion which may be more beneficial in specific patient populations.

The primary goal of this study was to evaluate damage to the Achilles tendon following burr resection of the calcaneal tuber.

Twenty, ten matched-pairs, thawed fresh-frozen cadaveric below-knee specimens were used to assess impact of MIS burr resection to posterior superior calcaneus and potential damage caused to the Achilles tendon.

We found a 15% incidence of partial Achilles tendon damage. No full thickness tearing or ruptures occurred, as well as no neurovascular damage in any specimen.

These findings support the use of MIS burr resection for use of calcaneal tuber resection in setting of Haglund's deformity while also underscoring the need for meticulous surgical planning to optimize patient outcomes. Further clinical trials are warranted to confirm these results and guide future surgical practices.