J Korean Orthop Assoc.  2010 Oct;45(5):356-362.

Surgical Management of Insertional Achilles Tendinopathy with Haglund's Deformity: A Preliminary Report

• Lee JY
• Jo SH
• Yang H

Abstract

PURPOSE
We wanted to report on treatment outcomes in insertional Achilles tendinopathy patients with Haglund's deformity that were operated on using a central achilles tendon splitting approach. MATERIALS AND
METHODS
We enrolled six cases of insertional tendinopathy with concomitant Haglund's disease who underwent an operation between January, 2007 and November, 2008 and for whom follow-up duration for more than 1 year were available. The mean age was 41.5 (21-62) years; the mean follow-up period was 16.3 (12-24) months. Resection of retrocalcaneal bony prominences and inflamed bursa with debridement of degenerative tendons was done using central splitting approach in all cases. A lateral ankle radiograph was used to assess the amount of bony resection. Clinical and functional evaluations were done before and after the operation.
RESULTS
In all cases, retrocalcaneal bony prominences were completely resected. Clinical and functional outcomes were significantly improved. One case had a mild tingling distal to the operative lesion. There were no other complications.
CONCLUSION
A central splitting approach is an efficient procedure that can provide sufficient exposure to remove pathologic lesions in patients with insertional Achilles tendinopathy accompanying Haglund's disease.

Keyword

achilles tendon; insertional achilles tendinopathy; Haglund's deformity; central splitting approach

MeSH Terms

Achilles Tendon
Animals
Ankle
Congenital Abnormalities
Debridement
Follow-Up Studies
Humans
Tendinopathy
Tendons

Figure

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  Figure 1 A 35-year-old male patient. (A) Lateral radiograph shows prominent posterior tuberosity of the calcaneus (Haglund deformity). (B) Postoperative radiograph demonstrates resection of posterior tuberosity superior to dorsal aspect of Achilles insertion, and tendon fixation with suture anchors.

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  Figure 2 Intraoperative photographs. (A) The central split approach of the Achilles tendon. (B) Resection of tuberosity. (C) After completion of bone resection and debridement, the suture anchor was fixed for reattachment of distal portion of the Achilles tendon.

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