Purpose
The purpose in this study was to compare endoscopic calcaneoplasty with a standard open technique in Haglund’s syndrome management.
Patients and methods
Two or three portal endoscopic calcaneoplasty was done in 14 patients (17 heels; nine females and five males), with a mean age of 29.7 years, and open calcaneoplasty using a lateral approach was done in 12 patients (17 heels; eight females and four males), with a mean age of 32.6 years. All patients had Haglund’s deformity on radiography and were resistant to conservative therapy for more than 6 months. All patients were evaluated preoperatively and postoperatively with the American Orthopaedic Foot and Ankle Society (AOFAS) score (Ankle–Hindfoot Scale).
Results
In the endoscopic group, the AOFAS scores averaged 63.4 points preoperatively and 88.5 points postoperatively (<0.001) at an average of 16 months (range: 12–23 months) of follow-up. In the open technique group, the AOFAS scores averaged 61.1 points preoperatively and 80.6 points postoperatively (<0.001), at an average of 20 months (range: 16–28 months) of follow-up. The scores after the endoscopic procedures were better than those after the open procedures. The time to recovery was similar in the two groups, but the endoscopic procedures were performed more quickly than the open procedures (50 min compared with 68 min) and were associated with fewer complications (0% compared with 1% regarding rate of infection, 5.8% compared with 23% regarding rate of altered sensation, and 5.8% compared with 17.6% regarding rate of scar tenderness).
Conclusion
Endoscopic technique for treatment of Haglund’s syndrome seemed to be a safe and efficient as the open technique and has the advantage of small incisions with better cosmetic appearance, less risk to weaken the Achilles tendon insertion that can cause tendon rupture, and also fewer wound complications such as dehiscence, painful or ugly scars, nerve entrapment within the scar, and hypoesthesia.