Boffeli Troy J, Peterson Matthew C
Regions Hospital/HealthPartners Institute for Medical Education, Saint Paul, MN, USA.
J Foot Ankle Surg. 2012 May-Jun;51(3):398-401. doi: 10.1053/j.jfas.2012.03.002. Epub 2012 Mar 23.
Surgical treatment of Haglund's deformity typically involves either bump removal or a closing wedge calcaneal osteotomy. Although bump removal may initially seem easier to perform and quicker to heal, there are advantages to avoiding bone resection adjacent to the Achilles tendon. Healing of the wedge osteotomy can be faster and more predicable than tendon healing at the Achilles insertion, which is beneficial to the young and active population that tends to have this condition. This article describes a reproducible Keck and Kelly closing wedge osteotomy technique that effectively decompresses the posterior/superior aspect of the calcaneus without need for dissection around the Achilles insertion. Our technique allows for consistent correction of Haglund's deformity, reliable symptom relief, and minimal opportunity for intraoperative or postoperative complications. Technique pearls include patient selection criteria for bump removal versus wedge osteotomy and a preoperative template protocol.
Haglund畸形的手术治疗通常包括去除骨赘或闭合楔形跟骨截骨术。虽然去除骨赘最初似乎更容易操作且愈合更快,但避免在跟腱附近进行骨切除有其优势。楔形截骨术的愈合可能比跟腱附着处的肌腱愈合更快且更可预测,这对易患此病的年轻活跃人群有益。本文介绍了一种可重复的Keck和Kelly闭合楔形截骨术技术,该技术可有效减压跟骨后上方,而无需在跟腱附着处周围进行解剖。我们的技术能够持续矫正Haglund畸形,可靠缓解症状,且术中或术后并发症的发生机会最小。技术要点包括骨赘去除术与楔形截骨术的患者选择标准以及术前模板方案。