Haglund's Foot Deformity

Similar Terms:Haglunds Syndrome,painful heel bumps

Haglund's foot deformity is a protrusion of the upper posterolateral calcaneum. It is characterized by pain (sometimes debilitating) on the back of the heel, at the region where the achilles tendon is inserted.

Most patients who suffer from Haglund’s syndrome are women between 15 to 35 years old, many of whom wear high heels constantly. This supports the hypothesis that the Haglund foot deformity or condition is generally caused by wearing high heels.

Haglunds syndrome is also very common in runners and is frequently misdiagnosed as achilles tendonitis

 

What are the symptoms of haglund's syndrome?

Symptoms of Haglund deformity include pain, blistering, and abrasion in the heel area, among others.

 

What causes haglunds deformity?

The cause of the Haglund deformity is still unknown, although its high incidence on women who wear high heels suggests that heeled shoes could be the cause. Pressure against the shoes (also called bursitis), worsened by the height of the heel, can lead to Haglund foot deformity.

 

How to diagnose?

The doctor usually assesses first if the foot is suffering from skin breakdown, in which case, he or she may take steps to prevent infection.

The doctor will also check for systemic arthropathy. Thorough examination of the foot and the lower leg may also be required. The doctor will look for changes in the local soft tissue and skin, observe the dimensions of the prominence, check for retro-Achilles bursitis (or in some cases achilles tendon tightness or insertional achilles tendonitis), and check for pes cavus.

 

Haglund's Deformity Correction and Treatment

Milder cases of Haglund’s syndrome can be self-treated. The swelling can be relieved by ice and compression.

If Haglund foot deformity is persistent, the doctors may also advise the patient to wear prescription shoes, heel grip pads, Achilles Heel pads, and orthotics. These all help relieve the heel of pressure, and eventually relieve Haglund deformity. Patients whose jobs require them to be on their feet the whole day may be required to wear special footwear. If this still does not solve the problem, surgical intervention may be offered.

In more sever cases when the bone is already enlarged or when the other treatment options are not acceptable to the patient, surgery may become necessary.

There are three approaches to surgery of Haglund’s syndrome:

Lateral approach:

provides very good exposure but increases the risk of damaging the sural nerve and the exposure of a petulant scar

Medial approach

Addresses all the problems of the lateral approach but does not provide good exposure.

Arthroscopic resection.

Surgery typically resections the (a) calcaneal prominence and the (b) interstitial bursa.

There is another surgical option, which makes the deformity a lot less protuberant via closing wedge osteotomy of the posterior calcaneum. Several successful accounts have so far been recorded, but this type of surgery has not yet been widely-accepted.

Remember that even if the surgery is successful, though, a lengthy post-operation recovery period is required. The patient may be immobilized for a long period. These days, doctors usually advise against cortisone injections because it increases the chances of Achilles tendon rupture. Patients are instead given apparatuses such as cast walking boots to render the area immobile as it heals.