Partial osteotomy of calcaneal tuberosity for Haglunds syndrome significantly improves AOFAS scores: study

Haglund’s syndrome is a painful condition involving a bony prominence on the posterosuperior aspect of the calcaneus, often leading to retrocalcaneal bursitis and Achilles tendinopathy. Conservative treatment options include non-steroidal anti-inflammatory drugs, heel lifts, footwear modifications, and physiotherapy. Surgical intervention becomes necessary when conservative methods fail. Partial osteotomy of the calcaneal tuberosity, by reducing the bony prominence, aims to relieve pressure on the Achilles insertion and retrocalcaneal bursa, thereby alleviating symptoms. Several techniques have been described, but outcomes vary depending on the surgical approach and patient compliance.

Ashin Khan et al conducted a study to evaluate the short-term functional outcome of partial calcaneal osteotomy using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score in a cohort of patients treated at a tertiary care teaching hospital in South India. The article has been published in ‘Journal of Orthopaedic Case Reports.’

12 adult patients with symptomatic Haglund’s syndrome underwent partial calcaneal tuberosity resection and bursectomy. Patients had failed ≥3 months of conservative care. Functional assessments (AOFAS hindfoot score) and lateral radiographs (Fowler–Philip angle, calcaneal pitch, and total calcaneal angle) were recorded preoperatively, and at 6 weeks, 3 months, and final follow-up (minimum 6 months).

The key findings of the study were:

• A case series of 10 patients, with 7 females and 3 males patients, with a mean age of 42 years (range 36–50).

• Mean AOFAS scores improved from 55.6 preoperatively to 77.5 at 6 months, indicating statistically and clinically significant improvement.

• No major complications were observed during the follow-up period.

The authors opined the clinical message – “Partial resection of the calcaneal tuberosity with bursectomy offers significant relief for patients with Haglund’s syndrome resistant to non-surgical measures. It improves functional outcomes with low complication rates when performed with meticulous technique.”

Further reading:

A Prospective Case Series: Functional Outcomes after Calcaneal

Tuberosity Partial Resection for Haglund’s Syndrome

Ashin Khan et al

Journal of Orthopaedic Case Reports 2025 December:15(12): Page 283-287