Dr. Patrick DeHeer, DPM - Haglund's Deformity Reduction Part 2 of 2

[jissa683]

Hello, Dr.

so i went to the doctor with this problem and he refused to do the surgery and explained that its a dangerous one because the bump is placed where the achilles tendon is and if it is cut I might not be able to walk properly and it would take much time to heal. is it true?

[naveslaikss]

how come its not bleeding?

[padeheer]

@naveslaikss We use a tourniquet which stops the blood flow. This allows us to see better during the surgery. Best Wishes.

Dr. Patrick A. DeHeer, DPM

[jbunn1895]

I had this surgery around 17 years ago when I was 13 years old. I was in a lot of pain at that time. The Dr. went in and shaved the bone. I have noticed over the past couple of months that the bone has grown back and I'm hacing pain again. It almost feels like the back part of my heel under my tendon is tight, especially after a long day. Do you think a repeat surgery would help it?

[padeheer]

@jbunn1895

You may be able to treat this non-surgically with stretching, anti-inflammatories, orthoses and appropriate shoe gear. If not then you may require surgical revision. Best wishes.

Dr. Patrick A. DeHeer, DPM

[JPSovereignStrikes]

i think i have this and now im terrified! i have all the symptoms.

[padeheer]

@JPSovereignStrikes It is really not too bad of a surgery to recover from. Best wishes.

Dr. Patrick A. DeHeer, DPM

[manjr]

G n' R foot surgery! Outstanding!

Thank you for the video, Dr. DeHeer. I think I have Haglund's, and it's good to know what I might be in for.

[padeheer]

@manjr Glad to help. Best wishes.

Dr. Patrick A. DeHeer, DPM

[lisaann7451]

Hello, Dr. Deheer. I had the haglands surgery in Sept. 2010. I had therapy and all but now I am trying to loose weight, and I think I over extended myself. Now my pain feels just like it did before the surgery but worse. Any ideas on what is going on or what I should do?

[padeheer]

@lisaann7451 It sounds like Achilles tendonitis. I would make sure you are stretched with a night splint to treat any equinus deformity, use a heel lift until symptoms are improved, oral steroids, ice and elevation, strappings, and finally orthoses. I use shockwave therapy if the above does not resolve the symptoms. Best wishes.

Dr. Patrick A. DeHeer, DPM

[padeheer]

You might ask about shockwave therapy of the area, which could help with the calcifications. Tendons are usually repaired directly, without a graft. Hope this helps. Best wishes.

Dr. Patrick A. DeHeer, DPM

[graham1972ad]

thank you for your reply. i am due for a check up in about 6 weeks so i will discuss your recommendations. sorry to be a pain but you didnt comment on the calcification. can anything be done. my surgeon says not, but then how do severed tendons get treated. cant they cut the damaged part out or transplant a tendon?

[graham1972ad]

i had this surgery 5 months ago. it reduced, but didnt completely, stop the pain around my heel/tendon. it also resulted in pain in the outer ankle due to fragments left from the surgery. i currently have heel inserts which help but again its not a total cure. i have some calcification of the tendon which wasnt treated. is that the reason for the soreness, or is 5 months too short a time to expect to be pain free?. what are my options and can anything be done about the calcification?

[padeheer]

@graham1972ad I would be concerned about the fragments causing the pain. Chronic tendonitis is also common after this surgery. I would start with physical therapy and give it 4 weeks or so. If that does not help, then I would consider shockwave treatments to the area. I hope this helps. Best wishes.

Patrick A. DeHeer, DPM

[PodiatrySoftware]

Nice video. Is it necessary to dorsiflex the foot when tying down the anchor for the Achilles to prevent equinus? (If you did, it was out of camera view). Thanks for your response.

[padeheer]

@PodiatrySoftware I usually will have a resident or assistant hold the foot in neutral position during tendon attachment. With a Haglund's repair, the majority of the tendon is still attached which will determine tendon length. Hope this helps.

Patrick A. DeHeer, DPM

[eBiology]

Very interesting approach towards placing the anchor into the calcaneus. I always thought a pilot hole would be drilled out and a suture anchor (with threads) threaded directly into the calcaneus. Are these "winged" anchors exclusive to DePuy?

[padeheer]

@eBiology There are some that screw and some are like drywall bolts with wings. The wings pop open once inserted. I use several companies, I think this one is from Mitek. Hope this helps. Best wishes.

Patrick A. DeHeer, DPM

[eBiology]

@padeheer The drywall example was on the tip of my tongue. Nevertheless, this approach must be a great time saver, considering the time needed to autoclave the various supplies required for drilling, drilling out the pilot hole, threading the anchor, etc. Very nice reduction nonetheless.

[lisaann7451]

My surgery is on monday.... I think I am having second thoughts... is that anchor necessary? What if the orthopedic doc is not going to trim the bone down?

Also, what is the anchor used for? Does the anchor stay in the heel bone?

[padeheer]

@lisaann7451 Hi, sorry for the delay getting back to you. The anchor is needed most of the time. They will remove the bone, that is the whole point of the surgery. Best wishes.

Patrick A. DeHeer, DPM

[lisaann7451]

My surgery is on monday.... I think I am having second thoughts... is that anchor necessary? What if the orthopedic doc is not going to trim the bone down?

Also, what is the anchor used for?

[lisaann7451]

My surgery is on monday.... I think I am having second thoughts... is that anchor necessary? What if the orthopedic doc is not going to trim the bone down?



[htmalmdn]

does the use of anchor is essential, it is very expesive, | think Icould dispence it?

thanks for your demonestration.

[padeheer]

Respond to this video...It is helpful but not essential. Most of the achilles tendon inserts into the medial aspect of the calcaneus. If you do not use an anchor, then I recommend immobilization for a longer period of time.

Patrick A. DeHeer, DPM

[akhileshvanam]

informative

[padeheer]

@akhileshvanam You are welcome, best wishes.

Patrick A. DeHeer, DPM

[jjpharissTheReal1]

that will hurt if he was awake lol

[akhileshvanam]

informative

[padeheer]

@jdaydesigns You are welcome. Best wishes on your recovery. Hang in there, it will get better.

Patrick A. DeHeer, DPM

[neomilly]

very interesting thankyou for letting us see this proceedure. very informative. liz

[iMeboTube]

im scared ! poor feet

[silverton7777]

scare tissue is comming need sound treatment in about a year,