Name:
Haglund’s Deformity Surgery - Excision of Prominent Tuberosity of Calcaneus
Description:
Haglund’s Deformity Surgery - Excision of Prominent Tuberosity of Calcaneus
Thumbnail URL:
https://cadmoremediastorage.blob.core.windows.net/a2391b38-44fd-4eef-87c0-185f81cab52d/videoscrubberimages/Scrubber_1.jpg
Duration:
T00H06M11S
Embed URL:
https://stream.cadmore.media/player/a2391b38-44fd-4eef-87c0-185f81cab52d
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/a2391b38-44fd-4eef-87c0-185f81cab52d/Haglund%e2%80%99s deformity Surgery- Excision of Prominent Tuberosit.mp4?sv=2019-02-02&sr=c&sig=69AFWfrLWWVPrNlGBNDQdyVoH%2BltqYk7BTEEHxZuLYs%3D&st=2025-02-23T18%3A29%3A28Z&se=2025-02-23T20%3A34%3A28Z&sp=r
Upload Date:
2025-02-23T18:34:28.5514385Z
Transcript:
Language: EN.
Segment:0 .
SHARATH K RAMANATH: Dear friends, we are watching Haglund deformity surgery. Haglund deformity is a prominent overgrown bone or the posterior tuberosity of calcaneus along with the calcaneal retro calcaneal bursa formation. With constant pain for the back of the heel while walking. This will be persistent and after we would have tried all the methods of conservative methods, this surgery can be performed.
SHARATH K RAMANATH: Here is a patient of a 50 year old, 52-year-old female with a pain of heel of more than three to four years duration. You can see that paramedian incision has been done. Now we are detaching the tendo achilles from the calcaneal at the tuberosity area. We are now detaching with a using, using knife which is the tendon is cut flush with the bone as is
SHARATH K RAMANATH: the length of the tendon should be maintained for the reattachment. When we cut the tendo achilles flush with the bone, you can see that we, we are not using retractors and we are not using anything to pull the skin so as to preserve the vascularity of this area, which is very precious. Once we detach the tendo achilles, we will then reflect it superiorly and check the in posterior aspect of the tendon to remove the bursa and to remove the calcified areas
SHARATH K RAMANATH: and then, we then we, then we concentrate on Haglund deformity or the bony spicule removal. With the usage of osteotome, and then we can use c-arm image intensifier to check the amount of bone which is removed. To smooth on the removed surface, we can use bone file and we can parallel simultaneously feel the bone with our fingers to see if there is any sharp ends or spicules or prominent projections which are to be removed so that the tendon attached will be smooth and the pain will be removed after this surgery.
SHARATH K RAMANATH: This attachment, reattachment of tendo achilles can be done by several methods like interosseous sutures, interference screws or button below the heel pad, or using the anchors, either one or two. Two anchors, as we use for rotator cuff, like a medial row and lateral row. In this case, like a proximal row and the distal row. Here we are using two loaded anchor, which is fixed to the proximal part of the calcaneus, where the first point of attachment of the tendon Achilles is made with the sutures of, of the anchors.
SHARATH K RAMANATH: And then these sutures are taken over the tendon Achilles and then reattached at the ends of the tender Achilles are reattached like a lateral row with a usage of several lock anchors. We have to make sure that we take equidistant bites and cover the whole span of the substance of the tendon so that the tendon is attached exactly like how it was before.
SHARATH K RAMANATH: And then we can use, you can, we can use image intensifier to assess the location of the swivel lock anchors. Here you can see that we are measuring the swivel lock anchor so as to how much we have to pull the the, the threads and these threads are passed in the eyelet of the swivel lock. Now we are fixing this lock to the distal row. While we are fixing, we have to make sure that it is in the sagittal plane.
SHARATH K RAMANATH: It is just above the paramedian area, just above the area where the bone touches the ground. And after we fix it, we assess the tension or tightness of the attached tendon Achilles and we can make a Thompson test to assess the integrity and how best, how how we have fixed the tendon. You can see that the all the four threads are now covered and this avoids the dogear formation and broader surface of attachment from the proximal to distal row of the tendon is now attached so that the healing will be faster.
SHARATH K RAMANATH: Surface area of attachment to the bone is bigger. The next, then we have to focus on the skin closure, which is very tender in this area. We have to use very closely using thin stitches and very closely used subcutaneous stitches and then if possible, to use 3-0 or 4-0 skin with stitches instead of the stapler.
SHARATH K RAMANATH: Thank you for watching this video. If you have liked, please press like button and don't forget to subscribe to my channel. Thank you. [VIDEO ENDS]
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