Haglund's deformity, also known as "pump bump," is a condition characterized by a bony enlargement at the back of the heel bone. This protrusion can cause irritation and inflammation of the surrounding soft tissues, leading to pain and discomfort, particularly when wearing shoes. Haglund's deformity surgery, also referred to as Haglund's exostectomy, aims to address this issue by removing the bony prominence and alleviating pressure on the affected area.
Haglund's deformity typically develops due to various factors, including biomechanical abnormalities, such as high arches or tight Achilles tendons, as well as wearing tight or ill-fitting shoes. Conservative treatments, such as shoe modifications, orthotic inserts, physical therapy, PRP injections, and anti-inflammatory medications, are often attempted first to alleviate symptoms. However, if these measures fail to provide relief, surgery may be recommended, especially in cases where the deformity causes significant pain or limits mobility.
Surgical Technique
Haglund's deformity surgery is usually performed under general anesthesia on an outpatient basis, allowing patients to return home the same day. The surgical technique involves making an incision at the back of the heel to access the affected area. The surgeon then carefully removes the bony prominence, also known as an exostosis, using specialized instruments. In some cases, a portion of the Achilles tendon may also be released or repositioned to reduce tension on the heel bone. Alternatively, if the Achilles tendon is degenerated, the incision is often made in the midline, and the degenerative portion of the tendon is excised along with the prominent bone. In some cases, a tendon may be transferred to replace a portion of the Achilles tendon that cannot be repaired. Once the necessary corrections are made, the incision is closed with sutures, and a dressing or bandage is applied to the wound.
Recovery
Following Haglund's deformity surgery, patients are typically advised to keep weight off the affected foot and elevate it to reduce swelling and discomfort. Crutches or a walking boot may be provided to assist with mobility during the initial stages of recovery. Physical therapy exercises to improve flexibility and strength in the ankle and calf muscles may also be recommended. Full recovery can take several weeks to months, depending on the extent of the surgery and individual healing factors.
Risks and Complications
While Haglund's deformity surgery is generally safe, like any surgical procedure, it carries certain risks and potential complications. These may include infection, delayed wound healing, nerve damage, blood clots, and adverse reactions to anesthesia. Additionally, there is a small risk of recurrence of the deformity or persistent pain following surgery. Patients are advised to discuss these risks with their surgeon and follow post-operative instructions carefully to minimize the likelihood of complications.
In conclusion, Haglund's deformity surgery offers a viable treatment option for individuals experiencing persistent pain and discomfort associated with this condition. By understanding the surgical procedure, recovery process, and potential risks involved, patients can make informed decisions in collaboration with their healthcare providers to achieve optimal outcomes and regain comfort and mobility in their feet. Early intervention and adherence to post-operative care are key to a successful recovery from Haglund's deformity surgery.
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