Haglund씨 병에서 시행한 내시경적 감압술의 결과 (The Results of the Endoscopic Decompression for the Treatment of Haglund’s Disease)

서지정보

· 발행기관 : 대한족부족관절학회
· 수록지 정보 : 대한족부족관절학회지 / 12권 / 2호 / 197 ~ 202페이지
· 저자명 : 안수한, 조형래, 홍성확, 왕태현

초록

Purpose: Haglund’s disease represents a painful heel caused by mechanically induced inflammation of the retrocalcaneal bursa
and insertional Achilles tendinosis may coexist. Traditional open surgery can cause complications such as skin breakdown,
painful scar and altered sensation around the heel. Endoscopic treatment offers the advantages that are related to minimally
invasive procedure and we evaluate the clinical results and operative techniques of endoscopic decompression of
retrocalcaneal space for Haglund’s disease.
Materials and Methods: Our retrospective study included seven heels in six consecutive patients for which nonoperative
treatment had failed and endoscopic decompression was performed. The mean age was forty-one years (range, 28 to 53
years). All of the patients had typical complaints of inflammation of the retrocalcaneal bursa and Fowler-Philip angle of
more than 75° and positive parallel pitch lines were present on the lateral calcaneal radiograph. The endoscopic
procedure consists of the resection of inflamed retrocalcaneal bursa and enough bone to prevent impingement of the
bursa between the calcaneus and Achilles tendon. All patients were evaluated with radiologic angle, visual analogue
scale (VAS) for pain and Ogilvie-Harris functional score. The mean follow-up was 18 months (range, 15 to 21 months).
Results: The mean operation time was 61 minutes (range, 50 to 85 minutes). VAS for pain and Fowler-Philip angle
were decreased from preoperative 8.7 and 82° to postoperative 2.3 and 57°, respectively. One patient with ankylosing
spondylitis had a fair result, 2 patients had good results and the remaining 3 patients had excellent results according
to Ogilvie-Harris functional score. There were no surgical complications such as infection, Achilles tendon avulsion
or abnormal heel sensation.
Conclusion: The endoscopic decompression for Haglund’s disease was demonstrated to have several advantages including
low morbidity, allowance of functional rehabilitation, short recovery time and quick sports resumption. However a
comparative study is needed to determine the value of endoscopic decompression and particular caution should be
exerted for the enthesiopathy.

영어초록

Purpose: Haglund’s disease represents a painful heel caused by mechanically induced inflammation of the retrocalcaneal bursa
and insertional Achilles tendinosis may coexist. Traditional open surgery can cause complications such as skin breakdown,
painful scar and altered sensation around the heel. Endoscopic treatment offers the advantages that are related to minimally
invasive procedure and we evaluate the clinical results and operative techniques of endoscopic decompression of
retrocalcaneal space for Haglund’s disease.
Materials and Methods: Our retrospective study included seven heels in six consecutive patients for which nonoperative
treatment had failed and endoscopic decompression was performed. The mean age was forty-one years (range, 28 to 53
years). All of the patients had typical complaints of inflammation of the retrocalcaneal bursa and Fowler-Philip angle of
more than 75° and positive parallel pitch lines were present on the lateral calcaneal radiograph. The endoscopic
procedure consists of the resection of inflamed retrocalcaneal bursa and enough bone to prevent impingement of the
bursa between the calcaneus and Achilles tendon. All patients were evaluated with radiologic angle, visual analogue
scale (VAS) for pain and Ogilvie-Harris functional score. The mean follow-up was 18 months (range, 15 to 21 months).
Results: The mean operation time was 61 minutes (range, 50 to 85 minutes). VAS for pain and Fowler-Philip angle
were decreased from preoperative 8.7 and 82° to postoperative 2.3 and 57°, respectively. One patient with ankylosing
spondylitis had a fair result, 2 patients had good results and the remaining 3 patients had excellent results according
to Ogilvie-Harris functional score. There were no surgical complications such as infection, Achilles tendon avulsion
or abnormal heel sensation.
Conclusion: The endoscopic decompression for Haglund’s disease was demonstrated to have several advantages including
low morbidity, allowance of functional rehabilitation, short recovery time and quick sports resumption. However a
comparative study is needed to determine the value of endoscopic decompression and particular caution should be
exerted for the enthesiopathy.

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