Deformities - Injuries

Haglund disease

Haglund disease is characterized by pain at the insertion of the Achilles tendon to the calcaneus usually associated with an osseous hyperostosis of this area. Achilles tendinitis may coexist.

In early stages conservative treatment is preferred. Heel elevation with special insoles, intermittent anti-inflammatory drugs, physiotherapy can be used for months.

In refractory cases surgery is a reasonable solution. The operative technique is difficult. The Achilles tendon is elevated at its insertion, any hyperostosis is excised, the tendon is reinserted with use of bony anchors and one of the flexor tendons of the foot (usually the flexor hallucis longus) may be used to reinforce the affected Achilles. Plaster cast immobilization is mandatory postoperatively.

Patients are discharged after a couple of days. Physiotherapy including eccentric exercises is recommended.

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All pictures originate from Mr M. Tyllianakis personal file