Surgical Management of Heel Pain · the calcaneus go big or go home ...

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HAGLUND’S SYNDROME: A TRIAD OF PAIN Jon Goldsmith, DPM KPMA 2019 Annual Scientific Meeting

Transcript of Surgical Management of Heel Pain · the calcaneus go big or go home ...

Page 1: Surgical Management of Heel Pain · the calcaneus go big or go home ...

HAGLUND’S

SYNDROME: A TRIAD

OF PAIN

Jon Goldsmith, DPM

KPMA 2019

Annual Scientific Meeting

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INTRODUCTION

◼ ANATOMY

◼ THE WORK UP

◼ HOW DO THEY WORK TOGETHER?

◼ TREATMENT

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ETIOLOGY

◼ SYSTEMIC DISEASE

◼ LOCAL PATHOLOGY

◼ OSSEUS

◼ SOFT TISSUES◼ BURSA

◼ NERVES

◼ ACHILLES

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HISTORY

◼ UK 1926-1927

◼ When does it hurt?

◼ Post static dyskinesia?

◼ What irritates it?

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PHYSICAL

◼ LOCATION

◼ EQUINUS

◼ DIFFERENTIALS

◼ Plantar fasciitis

◼ PTTD

◼ Calc stress fracture

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CONSERVATIVE TREATMENT

◼ NSAIDS

◼ HEEL LIFTS

◼ NIGHT SPLINTS

◼ IMMOBILIZATION

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PHYSICAL THERAPY

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INJECTION?

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ESWT

◼ Bridge between conservative and surgical care

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CONSIDERING SURGERY

◼ WHAT TO SURGICALLY ADDRESS

◼ PATIENT CONSIDERATIONS

◼ EXPECTATIONS

◼ OUT PATIENT

◼ POSITIONING

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APPROACHES

◼ MIDLINE

◼ MEDIAL

◼ LATERAL

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RETROCALCANEAL BURSA

◼ SOURCE OF PAIN

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THE ACHILLES

◼ REPAIR

◼ REATTACHMENT

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THE CALCANEUS

◼ GO BIG OR GO HOME

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ADJUNCTIVE WORK

◼ Radio-coblation

◼ PRP

◼ MAGIC DUST

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POST OPERATIVE

◼ NON WEIGHT BEARING

◼ 2 WEEKS

◼ PROTECTED WEIGHT BEARING

◼ 4 WEEKS

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SUMMARY

◼ ANATOMICALLY TIED TOGETHER

◼ THE HISTORY IS CRITICAL

◼ CONSERVATIVE CARE WORKS

◼ EQUINUS

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