Haglund's syndrome

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Haglund's syndrome
Specialty Podiatry

Haglund's syndrome is a group of signs and symptoms consisting of Haglund's deformity in combination with retrocalcaneal bursitis. [1] It is often accompanied by Achilles tendinitis. [2]

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Haglund's deformity

Right heel with a slightly developed upper heel spur. Heel with Haglund exotose 2.jpg
Right heel with a slightly developed upper heel spur.

Haglund's deformity was first described by Patrick Haglund in 1927. It is also known as retrocalcaneal exostosis, Mulholland deformity, and 'pump bump.' It is a prevalent clinical condition, but still poorly understood. Haglund's deformity is an abnormality of the bone and soft tissues in the foot. An enlargement of the bony section of the heel (where the Achilles tendon is inserted) triggers this condition. The soft tissue near the back of the heel can become irritated when the large, bony lump rubs against rigid shoes. [2]

Diagnosis

The etiology is not well known, but some probable causes, like a tight Achilles tendon, a high foot arch, and heredity, have been suggested. Middle age is the most common age of affection, females are more affected than males, and the occurrence is often bilateral. A clinical feature of this condition is pain in the back of the heel, which is more severe after rest. Clinical evaluation and lateral radiographs of the ankle are mostly enough to make a diagnosis of Haglund's syndrome. [2]

Prevention

To help prevent a recurrence of Haglund's deformity: [3]

Known Treatments

  1. Haglund's syndrome is often treated conservatively by altering the heel height in shoe wear, orthosis, physiotherapy, and anti-inflammatory drugs. Surgical excision of the bony exostoses of the calcaneum is only required in resistant cases. [2]
  2. Keck and Kelly Wedge Osteotomy [5]
  3. Excision of the retrocalcaneal bursa. [6]
  4. Calcaneal osteotomy. [6]
  5. Osseous debridement from the Achilles tendon. [6]
  6. Retrocalcaneal enthesophyte resection with functional Achilles tendon lengthening and buried knots. [6]

References

  1. ↑ Soft tissue rheumatology. Oxford University Press, 2004. 2004-01-22. p. 450. ISBN   978-0-19-263093-3.
  2. 1 2 3 4 Vaishya, R.; Agarwal, A.K.; Azizi, A.T.; Vijay, V. (2016). "Haglund's syndrome: A commonly seen mysterious condition". Cureus. 8 (10): e820. doi: 10.7759/cureus.820 . PMC   5101401 . PMID   27843738.
  3. 1 2 3 4 5 "Haglund's Deformity – Pump Bump on Heel | Foot Health Facts – Foot Health Facts". www.foothealthfacts.org. Retrieved 2022-12-09.
  4. ↑ "Achilles Tendinitis - OrthoInfo - AAOS". www.orthoinfo.org. Retrieved 15 June 2023.
  5. ↑ Cengiz, Bertan; Karaoglu, Sinan (2022-02-01). "Clinical results of the Keck and Kelly Wedge Osteotomy approach in Haglund's deformity: Minimum 3-year follow-up". Foot and Ankle Surgery. 28 (2): 269–275. doi: 10.1016/j.fas.2021.10.006 . ISSN   1268-7731. PMID   34674937. S2CID   239456331.
  6. 1 2 3 4 Cates, Nicole K.; Wagler, Emily C.; Chen, Shirley; Rubin, Laurence G. (2021). "Retrocalcaneal Enthesophyte Resection With Functional Lengthening of the Achilles Tendon and Buried Knot Technique: A Case Series". The Journal of Foot and Ankle Surgery. 60 (6): 1308–1314. doi:10.1053/j.jfas.2021.07.010. ISSN   1542-2224. PMID   34389217. S2CID   237010142.
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