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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE

A Journal on Physiopathology and Surgery of the Foot


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Chirurgia Del Piede 2000 March;24(1):43-8

language: Italian

Haglund's disease

Villani C., Persiani P., Chiozzi F., Billi A.


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Background. The authors comment on the radiographic evaluations reported in the literature (Fowler-Philipp, Pavlov-Heneghan and Chaveaux-Liet), underlining the importance of the Achilles tendon as a cause of painful symptoms.
Methods. They make a clinical and radiographical review of 10 feet undergoing surgery for heel pain secondary to retrocalcaneal deformity, at the 2nd Division of the Department of Orthopedics, ''La Sapienza'' University, Rome, and of 40 feet without heel pathologies. In the first group of 10 patients, 6 were females and 4 males, with an age range of 19 to 54 years. The control group included 15 males and 25 females with an age range of 18 to 66 years. All patients underwent a thorough clinical and radiographical examination of the foot, in both lateral and weight bearing conditions.
Results. Pavlon's measurement was positive in 80% of symptomatic patients and in 33% of the control population.
Conclusions. The authors suggest the need to evaluate the distance between the Achilles tendon and the heel as an additional radiographic index in order to evaluate the calcaneal osteotomy required to resolve the impingement producing heel pain. In view of the results obtained, they feel it is important to take into account ''calcaneal-Achilles decalage'', as well as the radiographical evaluations suggested in the literature, in order to reduce the risks of false positives and false negatives.

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