Comparative analysis of the functional outcomes of Haglund resection v/s comprehensive surgical management for Haglund syndrome: A retrospective study

Haglund syndrome is a complex condition characterized by the triad of Achilles tendonitis, retrocalcaneal bursitis, and a bony prominence on the posterosuperior aspect of the calcaneus. This syndrome leads to pain, swelling, and limited mobility in the ankle and hindfoot, significantly impacting patients' quality of life. The exact etiology remains unclear, but contributing factors include biomechanical abnormalities, footwear, and overuse. Non-surgical management options, such as physical therapy, orthotics, and corticosteroid injections, often provide temporary relief, but surgical intervention is frequently necessary for persistent symptoms. Surgical management options include isolated Haglund resection and comprehensive surgical approaches. Objective: To evaluate and compare the effectiveness of Haglund resection and comprehensive surgical management in treating Haglund syndrome, focusing on pain relief, functional improvement, infection rate, recurrence rates, and recovery times. Methods: We selected 20 patients who presented to the OPD of the Department of Orthopaedics who were diagnosed with Haglund syndrome. Out of the 20 patients, 10 cases underwent Haglund resection and the remaining 10 cases underwent Comprehensive Surgical Management. Patients were assessed preoperatively and postoperatively using the Foot and Ankle Outcome Score (FAOS), which evaluates pain, function, alignment, and quality of life. Results: Comprehensive surgical management demonstrated superior outcomes in terms of pain relief, functional improvement, and lower recurrence rates compared to Haglund resection. Patients who underwent comprehensive surgical management showed significant improvements in FAOS scores. Haglund resection resulted in faster recovery times, with patients returning to activities within 6 weeks, compared to 12 weeks for comprehensive surgical management. However, Haglund resection had higher recurrence rates compared to the comprehensive surgical management group. Conclusion: This study suggests that comprehensive surgical management may offer better outcomes for patients with Haglund syndrome, providing superior pain relief, functional improvement, and lower recurrence rates. However, Haglund resection remains a viable option for select patients with isolated bony prominence and mild symptoms, offering faster recovery times. Further prospective studies are needed to confirm these findings and establish clear guidelines for surgical management of Haglund syndrome.