00:00

Haglunds deformity correction; Arthrex Speedbridge technique

Overview

Subscribe to get full access to this operation and the extensive Foot Surgery Atlas.

SUBSCRIBE


Learn the Haglunds deformity correction; Arthrex Speedbridge technique surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Haglunds deformity correction; Arthrex Speedbridge technique surgical procedure.

There are three main varities of pathology effecting the area of the achilles tendon insertion and to which the description of a Haglunds’ deformity is commonly(and loosely) applied.

Most often the pathology is one of degenerative change at achilles the insertion associated intra-tendinous calcification. There may or may not be an element of anatomical prominence of the postero-lateral calcaneus associated. This tends to produce a fairly broad based swelling across the back of the heel. Usually the painful area is located laterally but it can on occasion be postero-medial.

Less commonly the achilles tendon is normal and the issue is an anatomical prominence of the postero-lateral corner of the calcaneus, causing pressure when in shoe-wear.

The third variation is a calcaneus that is anatomically  prominent posteriorly, laterally and also  superiorly. This can cause direct impingement upon the deep(anterior) aspect of the Achilles in the retro-calcaneal area.

These cases should be imaged using cross sectional imaging to determine  the location of both bony deformity and tendinopathy. This will assist in deciding upon the surgical approach to be taken. This will also on occasion show evidence of associated retro-calcaneal bursitis which should be intercurrently treated.

These variations in pathology can be treated using the same surgical principles and with successful outcome expected in the majority of patients. The key is to identify the exact location and nature of the pathology causing symptoms. Non-operative treatment is somewhat less successful when adopted here than for problems with the main body of the achilles tendon.

In my practice I use the Speedbridge for cases of insertional achilles tendinosis where there is significant intra-tendinous calcification that will require extensive detachment of the tendon for adequate access. The Speedbridge provides a far more robust level of fixation for the achilles than any alternatives. One can be as extensive as required therefore with the level of dissection. The technique is though without doubt more involved than simply using a postero-lateral or postero-medial approach and fixing the tendon back with a Bio-corkscrew anchor, which covered on OrthOracle at https://www.orthoracle.com/library/haglunds-deformity/

Generally the surgery is easier performed with the patient prone but as this technique demonstrates it cab be done with the patient well supported in a lateral position.

The Arthrex SpeedBridge implant itself is very much a really useful part of the surgical armamentarium available to treat Haglunds cases. It should be remembered however that of greater importance is identifying the various potential sources of symptoms and treating them all. Also whatever the operative technique used careful skin handling throughout is required as well as in the post-operative period. The soft tissue cover here is thin and prone to delayed healing.

 

Author:Mr Mark Herron FRCS

Institution: The Wellington Hospital, London, UK.

  • Each operation and the questions associated become a named course in the CPD section
  • The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
  • You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
  • The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
  • There are four possible answers of which one is correct (or on occasion more correct) than the others.
  • There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
  • The course is completed once all the lessons are read and quizzes submitted and passed.
  • On successful completion of each quiz you will receive validated CPD points that add to the certificate in your CPD folder.
  • Your dashboard also will contain a record of the time you have spent logged onto and using the site.
  • The timer suspends after 5 minutes though if there is no activity.
  • When you restart you will resume at the same point in the module.
  • Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
    The pass mark is 75%.
  • If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
  • Once these have been read you can re-do just the questions you failed on.
  • Once you have passed the quiz you can return at a future stage & resit .

CPD Points:

  • Operation Quiz – 1 CPD point
  • Surgical steps Quiz – 1/4 CPD point
  • Implants Quiz – 1/4 CPD point
  • Problem case Quiz – 1/2 CPD point

One CPD point equates to one hour of academic activity

COURSE

Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.

Our content is designed for both Surgeons in independent practice and Surgeons in training.

COURSE PROGRESS

  • Did you find this technique helpful?
  • YesNo

Lessons Status

Accreditations

Logo Logo Logo Logo Logo Logo Logo

Associates & Partners

Logo Logo Logo Logo Logo Logo