DeVries J George, Summerhays Ben, Guehlstorf Daniel W
Wheaton Franciscan Healthcare, Wauwatosa, WI 53226, USA.
J Foot Ankle Surg. 2009 Jul-Aug;48(4):447-51. doi: 10.1053/j.jfas.2009.03.004.
Haglund's triad consists of the simultaneous presentation of the following clinical entities: Achilles tendinosis, Haglund's deformity, and retrocalcaneal bursitis. In this retrospective study, we review outcomes following the surgical treatment of Haglund's triad by means of complete detachment and reattachment of the Achilles tendon, removal of the retrocalcaneal exostosis, and excision of the retrocalcaneal bursa through a medial J-shaped approach. Patients were identified via chart review, and sent consent forms and a questionnaire consisting of a visual analog scale (VAS), a satisfaction survey, and the Maryland Foot Score. Seventeen patients (22 feet) met the inclusion criteria and returned the consent and questionnaires. Their mean age was 51.6 +/- 11.6 years, and the mean duration of postoperative follow-up was 40.1 +/- 27.0 months. The mean preoperative VAS was 7.9 +/- 2.3, and the postoperative VAS was 1.6 +/- 1.3 (P < .001). The mean postoperative Maryland Foot Score was 91.5 +/- 9.1, with 16 good to excellent results. Of the 17 patients, 16 were satisfied and only 1 was somewhat unsatisfied. Four complications were observed, and 1 of these required further surgical intervention. The outcome of this study demonstrated that surgical correction of Haglund's triad using a medial "J" approach, complete detachment and reattachment of the Achilles tendon, exostectomy, and retrocalcaneal bursectomy provided patient satisfaction with limited complications.
Haglund三联征包括以下临床情况同时出现：跟腱腱病、Haglund畸形和跟腱后滑囊炎。在这项回顾性研究中，我们回顾了通过跟腱完全切断并重新附着、切除跟腱后外生骨疣以及经内侧J形入路切除跟腱后滑囊来手术治疗Haglund三联征的结果。通过病历审查确定患者，并发送同意书和一份由视觉模拟量表（VAS）、满意度调查和马里兰足部评分组成的问卷。17例患者（22只脚）符合纳入标准并返回了同意书和问卷。他们的平均年龄为51.6±11.6岁，术后平均随访时间为40.1±27.0个月。术前VAS平均为7.9±2.3，术后VAS为1.6±1.3（P<.001）。术后马里兰足部评分平均为91.5±9.1，16例结果为良好至优秀。17例患者中，16例满意，仅1例有点不满意。观察到4例并发症，其中1例需要进一步手术干预。本研究结果表明，采用内侧“J”形入路、跟腱完全切断并重新附着、骨疣切除术和跟腱后滑囊切除术对Haglund三联征进行手术矫正，可使患者满意，并发症有限。
4级。
