Deficiency Of Haglund's Limbs

This is a deformity in the foot that results in an enlargement of the boney section where the Achilles tendon inserts, causing Haglund's deformity.

The Achilles Tendon insertion site is swollen and painful as a result of Hagland's deformity, a prominent osseous prominence at the posterolateral corner of the calcaneus. It is associated with retrocalcaneal bursitis. Cavo varus deformities exacerbate this problem.

As early as 1928, Patrick Haglund described it, but prior to that "pump bump" and "winter heel" were also used to describe the condition.

Anatomy Pertinent to clinical practice

There are two bursae near the Achilles Tendon - the deep retrocalcaneal bursa and the superficial bursa - which originate from the gastrocnemius and soleus muscles. The Achilles Tendon inserts into the posterior surface of the calcaneus in the middle third. Inflammation can occur at these locations and bursitis can develop.

Infectious Diseases

Runners and women who wear heels frequently are most likely to suffer from Hugland's Deformity. It is most common in the female population between the ages of 15 and 35.

Physiology

Factors contributing to predisposition:

Idiopathic conditions are the most common
Haglund's deformity can also be caused by genetics (hereditary).
Because of the insertion of the calcaneus, the heel tilts backward into the Achilles Tendon in high arches. Due to the constant irritation of the back of the heel bone rubbing against the tendon, a bony protrusion develops and the bursa becomes inflamed.
An inflamed bursa and a tender Achilles tendon are compressing each other, causing pain.
Whenever the foot is walking on the outside of the heel, it wears the outer edge of the shoe, which rotates the heel inward. As a result, the calcaneus will grind against the tendon, causing an inflamed bursa to form.
Weight gain
Ailment
The bump will not be countered by wearing improper/tight shoes, but symptoms may result in bursitis.
Runners over practice.
Shoes that don't fit properly or are tight.
Due to the delineated subtalar joint, foot joints have altered biomechanics.
It is characterized by a high arch
Tendon tightness in the Achilles

Symptoms and signs

On the back of the heel, there is a noticeable bump or bony prominence.
Achy heels.
Foot pain that never goes away
An Achilles tendon that is swollen and painful
When one is inactive for long periods of time, they usually suffer from mild episodes of pain.
Joint mobility in the ankle is severely restricted.
The skin is red and swollen.
Wearing footwear with hard heel edges increases the risk of the bursa and Achilles tendon on the calcaneus becoming inflamed due to friction between the soft tissue at the back of the heel and the shoe.

Diagnosis by differentiating

Tendencia acuta
Bursitis of the retrocalcaneal
Bursitis of the calcaneus
Fibromyalgia of the feet
Achilles tendon avulsion

Diagnostics during the procedure

Bony protrusions can be identified with X-rays
Bursa and Achilles tendon pathology assessed with ultrasound
An MRI of the Achilles tendon and bursa is necessary for assessing the pathology of these structures

Examination of the body

Historically
A thorough evaluation is performed of the bursae, tendons, and calcaneus
In order to elicit pain, functional tests include tensile (hopping on toes), compressive (jumping lunge), and combinations of the two
The posterior heel is visible with a bump
Over the posterior heel, inflammation may be evident in the form of swelling, warmth, redness, and tenderness.

In order to relieve the associated symptoms of Hugland's deformity, conservative management is used, but it does not resolve it. Pain relief is recommended with anti-inflammatory medications, but corticosteroid injections are avoided since they can rupture the Achilles tendon.

Pain can be reduced in some cases by casting.
Swelling can be reduced with ice or cryotherapy.
Calcaneal tendon tension can be relieved with stretching exercises and physiotherapy.

Surgical procedures

Surgical options are considered when conservative treatment fails

Injuries to the Achilles tendon may require the removal of bony protrusions
The Achilles tendon may be avulsed if the bony protrusion is partially removed
(Keck and Kelly technique) A wedge calcaneal osteotomy is a procedure that closes the wedges on the bones

Incorporating physical therapy into management

As far as conservative management is concerned, physiotherapists play a critical role, especially when it comes to managing bursitis associated with Hugland's Deformity.

Tendinitis and bursitis management

Anti-inflammatory treatment:
Taking a break
Incapacitation
Aerated water
Infrared
Exercising the gastrocnemius and soleus eccentrically
The Achilles tendon is stretched

Management of the postoperative period

When managing these patients post-operatively, Achilles tendon rupture and injury are important risks to consider.

Approximately one year is needed for a full recovery after Haglund's resection.

Preventative measures

Education of patients
Friction between Achilles Tendon and bursa can be minimized by modifying aggravating factors
Shoes with rigid backs should be avoided by the patient.
Haglund's Deformity can be prevented by wearing appropriate shoe inserts if a patient has a high arch and a tight Achilles tendon.
The use of orthotics or arch supports is referred to as podiatry
The following tips can help you lose weight (if applicable)
Hard surfaces and uphills should be avoided by runners
Prevent stiffness by stretching your Achilles

An Overview of clinical outcomes

A bony protrusion on the heel's posterolateral part is known as Hugland's deformity. Usually, it affects young women. The back of the heel is often painful and swollen when it's caused by friction with incorrect footwear or biomechanics. As part of conservative management, inflammation is controlled, aggravating factors are modified, and eccentric training is implemented. The condition can be treated surgically by removing the bony protrusion in part or in full, but risks include Achilles tendon injury or rupture. A calcaneal osteotomy may be performed as an alternative to the surgical procedure.

You can contact our office at 949-588-8833, or visit our website at https://www.ocfootdoctor.com. Our offices are in Laguna Hills, Irvine, Mission Viejo, Aliso Viejo, Lake Forest, Foothill Ranch, and Costa Mesa.

📲 949-588-8833

🏢 24331 El Toro Rd, Suite 370 Laguna Woods CA 92637

🏢Irvine Medical Arts Building 113 Waterworks Way, Suite 250 Irvine, CA 92618

🌐 https://www.ocfootdoctor.com/

The information contained above is intended for general reference purposes only. It is not a substitute for professional medical advice or a medical exam. Always seek the advice of your physician or other qualified health professionals before starting any new treatment. Health information on this website MUST NOT be used to diagnose, treat, cure or prevent any disease without the supervision of your doctor.