S Saran Karthik, Elangovan Pradeep, Sekar Akshaya, Daya A Praveena, Kumar C Vinod, Raj P Vibishek, Vy Ashwin
Orthopedics, All India Institute of Medical Sciences Madurai, Madurai, IND.
Orthopedics and Traumatology, Chettinad Hospital and Research Institute, Chennai, IND.
Cureus. 2024 Nov 29;16(11):e74713. doi: 10.7759/cureus.74713. eCollection 2024 Nov.
Background Haglund's syndrome, a common cause of pain in the posterior heel that consists of painful swelling of the local soft tissues and prominence of the posterosuperior calcaneal projection, presents significant challenges in treatment, particularly when conservative management fails. This study evaluates the functional outcomes following oblique partial excision of the posterosuperior portion (calcaneal tuberosity osteotomy) of the calcaneus for Haglund's syndrome. Methods A cohort of 30 patients, aged 18 years and older, with persistent heel pain unresponsive to conservative treatments, underwent partial osteotomy using a medial or lateral approach. Patients were assessed pre-operatively and post-operatively at six weeks, three months, and six months using the American Orthopedic Foot and Ankle Society (AOFAS) scoring system. Data were analyzed using descriptive statistics and the Friedman test to evaluate changes in AOFAS scores over time. Results The mean AOFAS score improved significantly from 55.17 pre-operatively to 79.27 at six months post-operatively. At six months, 16 (53.3%) participants had AOFAS scores between 80-89, indicating good functional outcomes, while 14 (46.7%) had scores between 70-79. The improvement in functional outcomes was statistically significant (p < 0.001). The study also found both lateral and medial surgical approaches yielded similar results. Conclusion Partial osteotomy of the calcaneal tuberosity is a safe and effective surgical intervention for Haglund's syndrome, leading to significant functional improvements. The use of AOFAS scoring provides a reliable assessment of outcomes, confirming the procedure's efficacy.
Haglund综合征是足跟后部疼痛的常见原因,表现为局部软组织疼痛性肿胀和跟骨后上突突出,在治疗方面存在重大挑战,尤其是保守治疗失败时。本研究评估了跟骨后上部分(跟骨结节截骨术)斜行部分切除治疗Haglund综合征后的功能结局。方法:对30例年龄18岁及以上、足跟持续疼痛且保守治疗无效的患者,采用内侧或外侧入路进行部分截骨术。使用美国矫形足踝协会(AOFAS)评分系统在术前、术后6周、3个月和6个月对患者进行评估。采用描述性统计和Friedman检验分析数据,以评估AOFAS评分随时间的变化。结果:平均AOFAS评分从术前的55.17显著提高到术后6个月的79.27。6个月时,16例(53.3%)参与者的AOFAS评分在80 - 89之间,表明功能结局良好,而14例(46.7%)的评分在70 - 79之间。功能结局的改善具有统计学意义(p < 0.001)。研究还发现外侧和内侧手术入路产生的结果相似。结论:跟骨结节部分截骨术是治疗Haglund综合征的一种安全有效的手术干预方法,可带来显著的功能改善。使用AOFAS评分可对结局进行可靠评估,证实了该手术的疗效。