Zadek Osteotomy for Treatment of Haglund's Syndrome

Recruiting

• Conditions: Haglund's Disease

• Registration Number: NCT07157319
• Lead Sponsor: Sohag University

Brief Summary

Haglund's syndrome is an abnormality of the bone and soft tissues in the foot. An enlargement of the bony section of the heel (where the Achilles tendon is inserted) triggers this condition.

* symptom includes insertional Achilles tendinopathy (IAT), The patient with HS often has a red, irritated, painful heel. And they often complain the enlargement of the posterior heel, which make it more difficult to footwear or sport

* Zadek described the Zadek Osteotomy option for the treatment of Haglund's syndrome This operation can change the calcaneus' anatomical length and elevate the distal insertion point of the Achilles tendon

\- It is a prospective case series study that will be done in Orthopedics and Traumatology department of Sohag university hospitals on patients suffering from Haglund's syndrome and treated by Zadek osteotomy

* This study aims to evaluate short term clinical, radiological and functional outcomes of Zadek osteotomy for treatment of Haglund's syndrome

Detailed Description

Introduction

* In 1928, Patrick Haglund described the Haglund syndrome firstly. Haglund's syndrome is an abnormality of the bone and soft tissues in the foot. An enlargement of the bony section of the heel (where the Achilles tendon is inserted) triggers this condition. The soft tissue near the back of the heel can become irritated when the large, bony lump rubs against rigid shoes.

* symptom includes insertional Achilles tendinopathy (IAT), The patient with HS often has a red, irritated, painful heel. And they often complain the enlargement of the posterior heel, which make it more difficult to footwear or sport.

* There are many conservative treatment options to treat it, which contains rest, activity modification, ice, or footwear modification.

* When these treatment for more than 6 months has failed, surgical options will be considered.

* Common surgical methods, including Haglund deformity debridement, endoscopic calcaneoplasty, and Zadek osteotomy (ZO).

* Zadek described the ZO option for the treatment of HS firstly. It was later modified by Keck and ZO is a dorsal closing wedge calcaneal osteotomy that allows the tuberosity of Haglund deformity to be brought forward. This operation can change the calcaneus' anatomical length and elevate the distal insertion point of the AT.

Aim of the work

• This study aims to evaluate short term clinical, radiological and functional outcomes of Zadek osteotomy for treatment of Haglund's syndrome.

Patients and Methods

* It is a prospective case series study that will be done in Orthopedics and Traumatology department of Sohag university hospitals on patients suffering from Haglund's syndrome and treated by Zadek osteotomy

* We are aiming in this study to include patients within period between 4/2025 to 10/2025

Study Timeline

• Study Start: 2025-04-01
• Status Verified: 2025-08
• Study First Submitted: 2025-08-14
• Study First Submitted QC: 2025-08-28
• Last Update Submitted: 2025-08-28
• Study First Posted: 2025-09-05
• Last Update Posted: 2025-09-05
• Primary Completion: 2025-10
• Study Completion: 2025-12-01

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 30

Inclusion Criteria

• patients over 18 years of age and less than 60 Yrs
• All patients had at least six months of conservative treatment

Exclusion Criteria

1. patients below 18 years of age and more than 60 Yrs
2. patients of Haglund's syndrome with AT rupture or degeneration
3. uncontrolled diabetic patients with or without neuropathic joint destruction,
4. Infection such as osteomyelitis.
5. Charcot joint.
6. Peripheral vascular disease

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Primary outcomes for a Zadek osteotomy in Haglund's syndrome include: pain relief.	From enrollment and follow up to the end of 24 weeks	\- Pain Reduction: Marked improvement in pain, often measured by a Visual Analogue Scale (VAS) score, is a primary outcome, with significant reductions in pain intensity and frequency reported after the procedure.
functional improvement (measured by score VISA-A).	From enrollment and follow up to the end of 24 weeks	Functional Improvement: VISA-A (Visual Analogue Scale for Achilles Tendinopathy) Score: A successful outcome is characterized by an improvement in the VISA-A score, reflecting better function for the Achilles tendon.
radiological changes to the calcaneus	From enrollment and follow up to the end of 24 weeks	calcaneal length and tuberosity ratio (X/Y Ratio): The osteotomy modifies the calcaneus by shortening it and rotating the posterosuperior tuberosity, which reduces impingement on the Achilles tendon.; calcaneal pitch angle(calcaneal inclination angle): Studies have shown a reduction in the calcaneal pitch angle after Zadek osteotomy which is a relevant radiological parameter for Haglund's deformity
improved ankle motion (dorsiflexion),	From enrollment and follow up to the end of 24 weeks	Improvements in scores like the Tegner scale show a patient's ability to return to sports or other activities at a pre-injury level The Zadek osteotomy is known to improve the range of motion, specifically an increase in ankle dorsiflexion.
Patient Satisfaction:	From enrollment and follow up to the end of 24 weeks	High rates of patient satisfaction are a key indicator of a successful procedure, with many patients reporting positive experiences post-surgery

Trial Locations

Locations (1)

Faculty of medicine, Sohag University; 🇪🇬 Sohag, Egypt