Zadek Osteotomy for Treatment of Haglund's Syndrome
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- Primary outcomes for a Zadek osteotomy in Haglund's syndrome include: pain relief.
研究概览
简要总结
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
详细描述
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
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •patients over 18 years of age and less than 60 Yrs
- •All patients had at least six months of conservative treatment
排除标准
- •patients below 18 years of age and more than 60 Yrs
- •patients of Haglund's syndrome with AT rupture or degeneration
- •uncontrolled diabetic patients with or without neuropathic joint destruction,
- •Infection such as osteomyelitis.
- •Charcot joint.
- •Peripheral vascular disease
结局指标
主要结局
Primary outcomes for a Zadek osteotomy in Haglund's syndrome include: pain relief.
时间窗: 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).
时间窗: 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
时间窗: 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),
时间窗: 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:
时间窗: 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
次要结局
未报告次要终点
研究者
Mohamed Kamal Abdelhakeem
Orthopedics resident, Sohag University hospital
Sohag University