surgical management of heel pain · the calcaneus go big or go home
TRANSCRIPT
HAGLUND’S
SYNDROME: A TRIAD
OF PAIN
Jon Goldsmith, DPM
KPMA 2019
Annual Scientific Meeting
INTRODUCTION
◼ ANATOMY
◼ THE WORK UP
◼ HOW DO THEY WORK TOGETHER?
◼ TREATMENT
ETIOLOGY
◼ SYSTEMIC DISEASE
◼ LOCAL PATHOLOGY
◼ OSSEUS
◼ SOFT TISSUES◼ BURSA
◼ NERVES
◼ ACHILLES
HISTORY
◼ UK 1926-1927
◼ When does it hurt?
◼ Post static dyskinesia?
◼ What irritates it?
PHYSICAL
◼ LOCATION
◼ EQUINUS
◼ DIFFERENTIALS
◼ Plantar fasciitis
◼ PTTD
◼ Calc stress fracture
CONSERVATIVE TREATMENT
◼ NSAIDS
◼ HEEL LIFTS
◼ NIGHT SPLINTS
◼ IMMOBILIZATION
PHYSICAL THERAPY
INJECTION?
ESWT
◼ Bridge between conservative and surgical care
CONSIDERING SURGERY
◼ WHAT TO SURGICALLY ADDRESS
◼ PATIENT CONSIDERATIONS
◼ EXPECTATIONS
◼ OUT PATIENT
◼ POSITIONING
APPROACHES
◼ MIDLINE
◼ MEDIAL
◼ LATERAL
RETROCALCANEAL BURSA
◼ SOURCE OF PAIN
THE ACHILLES
◼ REPAIR
◼ REATTACHMENT
THE CALCANEUS
◼ GO BIG OR GO HOME
ADJUNCTIVE WORK
◼ Radio-coblation
◼ PRP
◼ MAGIC DUST
POST OPERATIVE
◼ NON WEIGHT BEARING
◼ 2 WEEKS
◼ PROTECTED WEIGHT BEARING
◼ 4 WEEKS
SUMMARY
◼ ANATOMICALLY TIED TOGETHER
◼ THE HISTORY IS CRITICAL
◼ CONSERVATIVE CARE WORKS
◼ EQUINUS