Treating Haglund's Deformity with percutaneous Achilles tendon decompression: a case series

Introduction: Haglund’s syndrome is a deformity of the postero-superior and lateral heel-shaped profile commonly associated with inflammation of the retro-calcaneal bursa and characterized by pain and swelling. Aim of the study was to evaluate the reliability and effectiveness of minimally invasive percutaneous surgical procedure for Achilles tendon decompression. Methods: From January 2014 to April 2016, a total of 21 continuous patients with Haglund’s deformity (15 men, 6 women, mean age of 40 years) were enrolled. The regularization of calcaneous profile and borsectomy were performed in all cases. The results were evaluated both clinically with American Orthopaedic Foot and Ankle Society hindfoot score (AOFAS-hindfoot), Visual Analog Scale (VAS) before surgery and at 6 months’ follow-up. Radiographic results were also collected using Fowler-Philip before the surgery and one-month follow-up. Results: The average AOFAS-hindfoot score increased from 50.57 to 97.42 (p<.00001). VAS score decreased from 6.85 to 0.19 (p<.00001) and the mean Fowler-Philip angle decreased from 79,57° to 53.76°(p<.00001). In our series, no complications were observed and all patients were satisfied at last follow-up. Conclusions: Our results suggest that Achilles decompression by percutaneous approach for painful Haglund’s deformity is a reliable and effective surgical procedure. Level of evidence: IV.

Introduction: Haglund's syndrome is a deformity of the postero-superior and lateral heel-shaped profile commonly associated with inflammation of the retro-calcaneal bursa and characterized by pain and swelling. Aim of the study was to evaluate the reliability and effectiveness of minimally invasive percutaneous surgical procedure for Achilles tendon decompression.Methods: From January 2014 to April 2016, a total of 21 continuous patients with Haglund's deformity (15 men, 6 women, mean age of 40 years) were enrolled. The regularization of calcaneous profile and borsectomy were performed in all cases. The results were evaluated both clinically with American Orthopaedic Foot and Ankle Society hindfoot score (AOFAS-hindfoot), Visual Analog Scale (VAS) before surgery and at 6 months' follow-up. Radiographic results were also collected using Fowler-Philip before the surgery and one-month follow-up.Results: The average AOFAS-hindfoot score increased from 50.57 to 97.42 (p<.00001). VAS score decreased from 6.85 to 0.19 (p<.00001) and the mean Fowler-Philip angle decreased from 79,57 degrees to 53.76 degrees(p<.00001). In our series, no complications were observed and all patients were satisfied at last follow-up.Conclusions: Our results suggest that Achilles decompression by percutaneous approach for painful Haglund's deformity is a reliable and effective surgical procedure.