Minimally Invasive Surgery Technique Is Safe and Effective for the Treatment of Haglund Deformity

Purpose: Haglund deformity, a painful prominence of the superior calcaneus, can result in significant disability and difficulty with shoe wear. Once nonoperative treatments have failed, surgical options, including endoscopic or open techniques, can help improve the patient’s quality of life. Open techniques have a higher rate of wound healing complications, while endoscopic techniques can be technically challenging and result in increased surgical time. Recently, the use and indications for minimally invasive surgery (MIS) techniques in foot and ankle surgery have expanded. This study reports outcomes of a MIS technique for treating Haglund deformity. Methods: Data were retrospectively collected on 34 consecutive patients who underwent an isolated calcaneal exostectomy without bursectomy through a fluoroscopically guided minimally invasive approach via a single lateral portal. Results: At a minimum of 24 months follow-up, there was improvement in preoperative to postoperative Foot Function Index (mean 53.6 + 3.8 to 9.3 + 1.4, P < .001) and visual analogue scores (VAS) (mean 6.6 + 0.65 to 0.9 + 0.29, P < .001). The average return to sports was 2.5 weeks (+0.6 weeks), and 100 percent of patients were satisfied with the procedure. There were no major complications, including wound infections or delayed healing concerns, nerve injury, or deep vein thrombosis. Conclusion: The results suggest the described MIS technique for Haglund deformity is safe and effective in reducing pain and allowing for rapid return to activities. Level of Clinical Evidence: Level 4.