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Comparative Study
. 2020 May 7;15(1):168.
doi: 10.1186/s13018-020-01687-6.

Comparison of dorsal closing wedge calcaneal osteotomy versus posterosuperior prominence resection for the treatment of Haglund syndrome

Zilu Ge  1 , Lin Ma  1 , Hong Tang  1 , Mingyu Yang  1 , Aining Yang  1 , Chengsong Yuan  1 , Xu Tao  1 , Binghua Zhou  1 , Kanglai Tang  1 , Wan Chen  2
Affiliations
Comparative Study

Comparison of dorsal closing wedge calcaneal osteotomy versus posterosuperior prominence resection for the treatment of Haglund syndrome

Zilu Ge et al. J Orthop Surg Res. .

Abstract

Background: Haglund syndrome is a common disease that causes posterior heel pain. This study compared the clinical outcomes of dorsal closing wedge calcaneal osteotomy (DCWCO) and posterosuperior prominence resection (PPR) for the treatment of Haglund syndrome.

Methods: This retrospective study included 12 patients who underwent DCWCO and 32 patients who underwent PPR from January 2010 to August 2016. Patients were evaluated using the American Orthopedic Foot Ankle Society ankle-hindfoot scale (AOFAS), Victorian Institute of Sport Assessment Scale for Achilles tendinopathy (VISA-A), Fowler-Philip angle, Bohler's angle, and calcaneal pitch angle preoperatively and postoperatively (at 3 months, 6 months, 1 year, and the latest follow-up).

Results: Both groups exhibited a significant increase in their AOFAS and VISA-A scores after surgery. The DCWCO group had lower AOFAS scores than the PPR group at 6 months (77.6 ± 5.1 vs. 82.8 ± 7.8; P = 0.037) but had higher scores at the latest follow-up (98.2 ± 2.3 vs. 93.4 ± 6.1; P = 0.030). The DCWCO group had lower VISA-A scores at 3 months (56.9 ± 13.9 vs. 65.2 ± 11.0; P = 0.044) but higher scores at the latest follow-up (98.2 ± 2.6 vs. 94.3 ± 5.0; P = 0.010) than the PPR group. Both groups exhibited significant changes in the Fowler-Philip angle and Bohler's angle after surgery. The postoperative Fowler-Philip angle of the DCWCO group was greater than that of the PPR group (35.9° ± 4.9° vs. 31.4° ± 6.2°; P = 0.026). However, there was no statistically significant difference in any other angle of the two groups postoperatively.

Conclusions: Compared to the PPR group, the DCWCO group had poorer short-term clinical outcomes but provide better long-term function and symptom remission. This method can be a good option for those patients with higher functional expectations.

Keywords: Dorsal closing wedge calcaneal osteotomy; Haglund syndrome; Posterosuperior prominence resection.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a Surgical incision. b Cut line of the calcaneus. c Two partially threaded cannulated screws used for fixation
Fig. 2
Fig. 2
Before and after dorsal closing wedge calcaneal osteotomy (a and b). Before and after posterosuperior prominence resection (c and d)
Fig. 3
Fig. 3
Radiographic indices evaluated using standing lateral foot radiograph. a Fowler-Philip angle. b Calcaneal pitch angle. c Bohler’s angle
Fig. 4
Fig. 4
The comparison outcomes of two groups at preoperatively, 3, 6, 12 months, and last follow-up. a AOFAS score. b VISA-A score. *Significant difference between the two groups
See this image and copyright information in PMC

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