Medipol University, Medical School, Department of Orthopaedics and Traumatology, İstanbul, Turkey.
Medipol University, Medical School, Department of Orthopaedics and Traumatology, İstanbul, Turkey.
Foot Ankle Surg. 2021 Jun;27(4):421-426. doi: 10.1016/j.fas.2020.05.009. Epub 2020 Jun 8.
Haglund syndrom is characterized as a painful posterosuperior deformity of the heel with possible causes as tight Achilles tendon, high-arched foot and tendency to walk on the outside of the heel. Surgical treatment may be recommended in cases where of insufficient response to nonoperative treatment. This study aims to evaluate the clinical and radiographic results of central Achilles tendon splitting and double-row suture anchor technique in the surgical treatment of patients with Haglund syndrome.
27 patients with Haglund syndrome who underwent central Achilles tendon splitting and double-row suture anchor were retrospectively evaluated. The results were evaluated by the pre- and post-operative American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale and visual analogue scale (VAS). All patients were evaluated radiographically to assess lateral talus-first metatarsal angle (TMTA), Calcaneal pitch angle (CPA), and the Fowler-Philip angle (FPA) preoperatively and postoperatively.
The mean preoperative AOFAS score was 47 ± 7 points; at the end of the follow-up period, it increased to 92 ± 4 points (p < 0.001). The mean preoperative VAS score was 9 ± 0.9 points; at the end of the follow-up period, it was 2 ± 0.6 points (p < 0.001). The lateral TMTA (preoperative: 5° ± 2°; follow-up: 4° ± 2°; p < 0.001), CPA (preoperative: 21° ± 5°; follow-up: 20° ± 5°; p = 0.005) and FPA (preoperative: 55° ± 6°; follow-up: 32° ± 3°; p < 0.001) values decreased at the end of the follow-up period.
In the absence of an improvement to nonoperative treatment methods, central Achilles tendon-splitting approach appears to be an effective and safe treatment option.
Level IV, retrospective case series.
Haglund 综合征的特征为跟骨后上方疼痛畸形，可能的病因包括跟腱紧张、高弓足和倾向于脚跟外侧着地。对于非手术治疗反应不佳的病例，可能需要推荐手术治疗。本研究旨在评估中央跟腱切开和双排缝线锚定技术在 Haglund 综合征患者手术治疗中的临床和放射学结果。
回顾性评估了 27 例接受中央跟腱切开和双排缝线锚定的 Haglund 综合征患者。通过术前和术后美国矫形足踝协会（AOFAS）踝关节-后足量表和视觉模拟量表（VAS）评估结果。所有患者均进行影像学评估，以评估术前和术后外踝-第一跖骨角（TMTA）、跟骨倾斜角（CPA）和 Fowler-Philip 角（FPA）。
平均术前 AOFAS 评分为 47 ± 7 分；随访期末，增加至 92 ± 4 分（p < 0.001）。平均术前 VAS 评分为 9 ± 0.9 分；随访期末，为 2 ± 0.6 分（p < 0.001）。外侧 TMTA（术前：5°±2°；随访：4°±2°；p < 0.001）、CPA（术前：21°±5°；随访：20°±5°；p = 0.005）和 FPA（术前：55°±6°；随访：32°±3°；p < 0.001）值在随访期末均降低。
在非手术治疗方法无改善的情况下，中央跟腱切开术似乎是一种有效且安全的治疗选择。
IV 级，回顾性病例系列。
