Heel nodules and Achilles heel attachment inflammation, Haglund’s triad.

Patients with these symptoms have pain and chafing discomfort above the heel, which can be due to three main reasons. One is a congenital “bone nodule” which is directed straight back or slightly to the outside. It may be due to an inflammation of the Achilles tendon attachment to the heel bone, or swelling of the bursa at front of the Achilles tendon, or a combination of all three.

Conservative treatment is taking weight away from the heel section of the shoes. Using only slippers/shoes without a heel cup.

If this still does not produce the desired results, there are two different types of surgery to propose. The first is called resection surgery and involves removing the bone nodule on the back of the heel through an incision through or with relief of the Achilles tendon. The second is called a wedge osteotomy in which the Achilles tendon is not moved, but the Achilles heel attachment or “lump” on the heel bone is instead folded forward.

The procedure is performed under general anesthetic as day surgery that takes about 45 minutes. Plaster of Paris/orthosis for 6 weeks post-surgery, no weight on the foot during this time. The sutures are removed after 3 weeks. Sick leave for 8-10 weeks. Prolonged exercise after surgery, return to full activity takes approximately 10-12 months.