Minos Ε. Tyllianakis MD, PhD

Haglund’s disease is characterized by pain at the insertion of the Achilles tendon to the calcaneus usually associated with an osseous hyperostosis of this site. Achilles tendinitis may coexist. The commonly found spur in radiographs is not necessarily related to the disease.

In early stages conservative treatment is preferred. Heel elevation with special insoles, intermittent anti-inflammatory drugs, physiotherapy can be used for months.

In refractory cases surgery is indicated. The operative technique includes Achilles tendon elevation at its insertion, excision of any hyperostosis and tendon reinsertion to the bone with the use of bony anchors. One of the flexor tendons of the foot can be used to reinforce the affected Achilles. Plaster cast immobilization is mandatory postoperatively.

Patients are discharged on the first postoperative day. Physiotherapy including eccentric exercises is recommended.