[Arthroscopic Haglund deformity exostosis resection].

IF 1 4区医学 Q3 ORTHOPEDICS

Operative Orthopadie Und Traumatologie Pub Date : 2025-06-24 DOI:10.1007/s00064-025-00908-7

Klaus Edgar Roth, Kajetan Klos, Robert Ossendorff, Philipp Drees, Hazibullah Waizy

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引用次数: 0

Abstract

Objective: Treatment of symptomatic Achilles tendinopathy.

Indications: Impingement between the calcaneus and the Achilles tendon.

Contraindications: General contraindications. Active soft tissue infection.

Surgical technique: Incision medial and lateral to the distal portion of the Achilles tendon at the level of the lower ankle joint, if necessary under X‑ray control. Blunt preparation of the two portals (laterally, taking into account the course of the sural nerve) towards the posterior process of the calcaneus with a curved clamp. Insertion of the arthroscope into the lateral portal and the shaver into the medial portal. Resection of the bursa and visualization of the insertion area of the tendon. Insertion of the bone acromionizer or a burr to resect the offending bone; changing the portal and removing bone portions on the medial side of the calcaneus. If necessary, additional transachillary incision to remove the bone near the insertion. Wound closure.

Postoperative management: Immobilization of the foot in equinus position for 3-5 days in a dorsal splint. Retention in a walker for a further 2 weeks after the swelling has subsided. Weight bearing after 3 weeks.

Results: A total of 26 patients were retrospectively evaluated with a mean follow-up time of 25 ± 6 months. The Foot Function Index (FFI) improved from 62 preoperatively to 7 points at the last follow-up examination. The final visual analog scale foot and ankle (VAS-FA) score was recorded as 89. Residual symptoms were present in 15% of patients.

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关节镜下Haglund畸形外植体切除术。

目的：对症跟腱病的治疗。适应症：跟骨与跟腱之间的撞击。禁忌症：一般禁忌症。活动性软组织感染。手术技术：在踝关节下方的跟腱远端内侧和外侧切口，必要时在X线透视下进行。用弯曲钳钝准备两个门静脉（外侧，考虑到腓肠神经的走行）朝向跟骨后突。关节镜插入外侧门静脉剃刀插入内侧门静脉。切除滑囊，显露肌腱止点。插入骨肩峰化剂或毛刺以切除有问题的骨；改变门静脉并去除跟骨内侧的骨部分。如有必要，可进一步经腋窝切口去除植入处附近的骨。伤口关闭。术后处理：用背夹板固定足跖3-5天。肿胀消退后，在助行器中再留置2周。3周后负重。结果：回顾性评估26例患者，平均随访时间为25 ±6个月。足部功能指数（FFI）由术前62分改善至末次随访时的7分。最终足踝视觉模拟量表（VAS-FA）评分为89分。15%的患者存在残留症状。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Operative Orthopadie Und Traumatologie ORTHOPEDICS-

CiteScore

2.10

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Orthopedics and Traumatology is directed toward all orthopedic surgeons, trauma-tologists, hand surgeons, specialists in sports injuries, orthopedics and rheumatology as well as gene-al surgeons who require access to reliable information on current operative methods to ensure the quality of patient advice, preoperative planning, and postoperative care. The journal presents established and new operative procedures in uniformly structured and extensively illustrated contributions. All aspects are presented step-by-step from indications, contraindications, patient education, and preparation of the operation right through to postoperative care. The advantages and disadvantages, possible complications, deficiencies and risks of the methods as well as significant results with their evaluation criteria are discussed. To allow the reader to assess the outcome, results are detailed and based on internationally recognized scoring systems. Orthopedics and Traumatology facilitates effective advancement and further education for all those active in both special and conservative fields of orthopedics, traumatology, and general surgery, offers sup-port for therapeutic decision-making, and provides – more than 30 years after its first publication – constantly expanding and up-to-date teaching on operative techniques.