Background: Haglund's deformity enlarges the posterosuperior tuberosity of the calcaneus that is usually linked to insertional Achilles tendonitis. It can induce inflammation of the posterior calcaneal bursa, which results in pain edema. This study aimed to assess the effectiveness safety of the mini-open tendon Achilles splitting technique for treatment of Haglund's deformity, to improve symptoms enhance the stability of the tendon by securing it to the calcaneus using anchor suture which prevents tendon rupture especially if the tendon is degenerated debridement is required.

Methods: We conducted a retrospective cohort study on 15 cases non-athlete's feet with Haglund syndrome treated by tendon Achilles splitting technique, which involved completely excising the bony prominence and posterior calcaneal bursae before re-attaching the tendon Achilles with anchor sutures to the calcaneus. The follow-up for was at least three years post-surgery for all patients. AOFAS was used to evaluate the results.

Results: There was a highly statistically significant increase (p<0.001) in AOFAS score postoperative compared to preoperative (61.37 ± 8.46 versus 87.65 ± 7.53) with percent of increase 42.8%. Regarding correlation between percent of change in AOFAS score and different parameters among the studied cases, there was a statistically significant negative correlation between percent of increase in AOFAS score duration of symptoms (r= -0.29, p=0.04) and operation duration (r=0.36, P=0.01).

Conclusions: Suture anchor reattachment of tendon Achilles following mini-open tendon splitting to excise the Haglund's deformity could be a very effective approach for surgical removal of the exostosis with hopeful results with a minimal complication rate