Achilles Tendon Haglund Resection
A bump at the back of the heel back can relate to a bony swelling known as a Haglund deformity. This can irritate when wearing shoes and lead to insertional Achilles tendinopathy. For more information, see the sections below.
Why have the surgery?
If you have developed a Haglund bump at the back of your heel, then you might struggle to wear shoes. The back of the shoe can rub against the bump to cause skin irritation, redness and pain. This is occasionally known as a 'pump-bump,' in recognition of ladies pump shoes. An operation to remove the bump may consequently help these symptoms.
How is surgery performed?
The operation is typically performed under a general anaesthetic. An incision is made over the bump and the insertion of the Achilles tendon which may be diseased is peeled off, and damaged tissue is debrided. The bump of bone known as the Haglund bump is then removed and the Achilles tendon is reattached to the heel bone.
What are the benefits?
Surgery physically removes the bump as well as the worn out and diseased Achilles tendon. If all goes well, then the bump is taken away and no longer causes pain from either the tendon or the bump rubbing against shoe-wear.
What are the risks?
All operations have risks, but the commonest and most concerning for this surgery are: - Recurrence, meaning that the problem comes back. - Wound breakdown, since the skin in this area is very thin and has a poor blood supply. - Blood clots, which can form in the leg and travel up to the lung where they can be fatal. This list is not exhaustive and Mr Patel can talk you through them all in more detail during a consultation.
What recovery is involved?
A plaster cast is used to protect the wound site after surgery. Patients will not be allowed to place any weight on the leg for the first two weeks, after which time, a wound inspection will then take place. Depending upon how strong the repair is will dictate if a patient can start walking in a pneumatic boot straight away or whether a further period of time is need in plaster. Physiotherapy typically starts after four to six weeks and involves regaining strength and range of motion.
Any other considerations?
Not all patients with a Haglund bump need surgery. It is only indicated if non-surgical means have failed, and symptoms are severe enough to stop everyday functional tasks.