Complications Following Surgical Treatment of Haglund's Syndrome With and Without Flexor Hallucis Longus Tendon Transfer.
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2024-12
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Abstract
Background
In the surgical treatment of Haglund syndrome, combining a flexor hallucis longus (FHL) tendon transfer with Achilles tendon may improve plantarflexion strength and reduce strain on the repaired Achilles tendon. However, there is limited research comparing complication rates between surgical approaches with or without concurrent FHL tendon transfer.Methods
This was retrospective study of patients who underwent surgical management for Haglund syndrome between January 2015 and December 2023. Surgical management included open central-splitting Achilles tendon débridement, Haglund prominence resection, and subsequent Achilles tendon reattachment, either with or without concurrent FHL tendon transfer. Patient demographics, comorbidities, and postoperative complications were collected. Statistical analysis was conducted to compare outcomes between the two groups.Results
Among the 390 patients who underwent surgical intervention for Haglund syndrome, 52 individuals received FHL tendon transfer. The average follow-up duration was 10.1 ± 12.9 months. Overall, complications included persistent pain (10.3%), wound breakdown (8.2%), infection (1.8%), plantar flexion weakness (1.5%), and Achilles tendon rupture (0.3%). No notable difference was observed in complication rates between the two groups. However, wound breakdown was higher in the FHL tendon transfer group compared with the non-FHL group (P = 0.5). No patients who received a FHL tendon transfer experienced a postoperative Achilles tendon rupture.Conclusion
In the largest study of patients who underwent surgical treatment for Haglund syndrome, with or without FHL tendon transfer, the overall complication rate was comparable. However, the FHL tendon transfer group exhibited a higher tendency for wound breakdown.Type
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Anastasio, Albert T, Alexandra N Krez, Katherine M Kutzer, Kevin A Wu, Kali J Morrissette, Zoe W Hinton, Andrew E Hanselman, Karl M Schweitzer, et al. (2024). Complications Following Surgical Treatment of Haglund's Syndrome With and Without Flexor Hallucis Longus Tendon Transfer. Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, 8(12). 10.5435/jaaosglobal-d-24-00346 Retrieved from https://hdl.handle.net/10161/34849.
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Scholars@Duke
Andrew Egon Hanselman
I specialize in treating patients with all types of foot and ankle problems. Whether it's a simple ankle sprain or a complex foot/ankle reconstruction, I take pride in providing my patients with the expertise and resources here at Duke University but with the availability and convenience of a community-based setting. I enjoy treating patients of all ages with the goal of getting them back to their full activity as quickly and safely as possible. Most importantly, I believe in educating my patients about their issues, allowing them to better understand their health, how it affects their overall well-being, and providing them with the knowledge to become an integral part of their own healing process. Although some patients may require surgery, I try my best to maximize non-surgical treatment, knowing how much of an impact these decisions will have on someone's day-to-day life.
Karl Martin Schweitzer
My pursuit of a career in orthopaedics has come as no surprise to those around me. Growing up on our family horse farm in Mechanicsburg, Pa., afforded me many mechanical tasks. Foot and ankle orthopaedic surgery was an obvious choice: the diverse patient population, challenging surgeries, exciting research, and the ability to help my patients get back to the activities they enjoy most.
I do not take for granted my wonderful mentors throughout residency and fellowship training. I am thankful to be practicing back where my interest in foot and ankle was first ignited. My wife Samantha and I are excited to be back living in the Triangle.
As medical missionary, Dr. Albert Schweitzer said, “At times our own light goes out and is rekindled by the spark from another person. Each of us has cause to think with deep gratitude of those who have lighted the flame within us.” It is my responsibility, but also privilege as a surgeon, to empower my patients with ‘that light’, through optimism, knowledge, and ultimately relief, through both non-operative and surgical means.
Samuel Bruce Adams
Mark Erik Easley
James Albert Nunley
My current research interests are both clinical and basic science. Currently, in the Orthopaedic Research Laboratory, we are investigating the biomechanical properties of the deltoid ligament in the ankle. This is a clinically relevant problem and we will hopefully identify ways to improve the correction of the adult relaxed flat foot. We are also performing a preliminary investigation into the blood supply of the distal tibia to look for a vascularized bone transfer.
We have recently completed a biomechanical study looking at the strength of fixation for proximal metatarsal osteotomies in the correction of hallux valgus and that information has been submitted for publication.
Clinical projects have looked into nerve palsies after total elbow replacement and to reconstructive upper and lower extremity surgery.
Annunziato Amendola
Chief of Sports Medicine
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