Anastasio Albert T, Krez Alexandra N, Kutzer Katherine M, Wu Kevin A, Morrissette Kali J, Hinton Zoe W, Hanselman Andrew E, Schweitzer Karl M, Adams Samuel B, Easley Mark E, Nunley James A, Amendola Annunziato
From the Department of Orthopedic Surgery, Duke University Hospital, Durham, NC.
J Am Acad Orthop Surg Glob Res Rev. 2024 Dec 8;8(12). doi: 10.5435/JAAOSGlobal-D-24-00346. eCollection 2024 Dec 1.
In the surgical treatment of Haglund syndrome, combining a flexor hallucis longus (FHL) tendon transfer with Achilles tendon may improve plantarflexion strength and reduce strain on the repaired Achilles tendon. However, there is limited research comparing complication rates between surgical approaches with or without concurrent FHL tendon transfer.
This was retrospective study of patients who underwent surgical management for Haglund syndrome between January 2015 and December 2023. Surgical management included open central-splitting Achilles tendon débridement, Haglund prominence resection, and subsequent Achilles tendon reattachment, either with or without concurrent FHL tendon transfer. Patient demographics, comorbidities, and postoperative complications were collected. Statistical analysis was conducted to compare outcomes between the two groups.
Among the 390 patients who underwent surgical intervention for Haglund syndrome, 52 individuals received FHL tendon transfer. The average follow-up duration was 10.1 ± 12.9 months. Overall, complications included persistent pain (10.3%), wound breakdown (8.2%), infection (1.8%), plantar flexion weakness (1.5%), and Achilles tendon rupture (0.3%). No notable difference was observed in complication rates between the two groups. However, wound breakdown was higher in the FHL tendon transfer group compared with the non-FHL group (P = 0.5). No patients who received a FHL tendon transfer experienced a postoperative Achilles tendon rupture.
In the largest study of patients who underwent surgical treatment for Haglund syndrome, with or without FHL tendon transfer, the overall complication rate was comparable. However, the FHL tendon transfer group exhibited a higher tendency for wound breakdown.
在Haglund综合征的外科治疗中，将拇长屈肌腱（FHL）转移与跟腱结合可能会提高跖屈力量，并减少修复后跟腱的张力。然而，比较有无同时进行FHL肌腱转移的手术方法之间并发症发生率的研究有限。
这是一项对2015年1月至2023年12月期间接受Haglund综合征手术治疗患者的回顾性研究。手术治疗包括开放性中央劈开跟腱清创、Haglund隆突切除术以及随后的跟腱重新附着，有无同时进行FHL肌腱转移。收集患者的人口统计学资料、合并症和术后并发症。进行统计分析以比较两组的结果。
在390例接受Haglund综合征手术干预的患者中，52例接受了FHL肌腱转移。平均随访时间为10.1±12.9个月。总体而言，并发症包括持续疼痛（10.3%）、伤口裂开（8.2%）、感染（1.8%）、跖屈无力（1.5%）和跟腱断裂（0.3%）。两组之间的并发症发生率没有显著差异。然而，FHL肌腱转移组的伤口裂开发生率高于非FHL组（P = 0.5）。接受FHL肌腱转移的患者均未发生术后跟腱断裂。
在这项针对接受或未接受FHL肌腱转移的Haglund综合征手术治疗患者的最大规模研究中，总体并发症发生率相当。然而，FHL肌腱转移组的伤口裂开倾向更高。
