OPERATIVE MANAGEMENT OF HAGLUNDS DEFORMITY IN THE NONATHLETE - A RETROSPECTIVE STUDY

Haglund's deformity, or ''pump bump,'' is a common cause of posterior heel pain. Management of the condition usuary consists of nonoperative therapy. This study presents a retrospective study of 65 cases (53 pa tients), with symptomatic Haglund's deformity in nonathletes (13 male and 40 female), who presented during a 4-year period (1939-1994). Sixt y-five percent (39 heels) of these patients failed to respond to nonop erative therapy for an average of 62 weeks, (range, 4-260 weeks). This group of patients went on to operative treatment. Surgical management consisted of excision of the posterior calcaneal tuberosity through a medial longitudinal incision with debridement, reattachment of the Ac hilles tendon using bone anchors, and 4 weeks of postoperative immobil ization. Thirty-nine patients (14%) were contacted for follow-up. The average follow-up period for these patients was 155 weeks, (range, 92- 335 weeks). There were 50% excellent results, 47% good results, 3% fai r results (1 patient), and no poor results. The: Maryland Foot Score f or operated heels was an average of 67/100 preoperative and an average of 92/100 postoperative. On unoperated heels the score was an average of 81/100 at first evaluation and an average of 86/100 at final evalu ation. Complications included one recurrence of painful prominence, on e wound infection, and one incisional neuroma. The outcome of these ca ses demonstrated that in those patients who fail nonoperative treatmen t, surgical treatment of Haglund's deformity produces a predictably go od surgical result when performed using the technique described.