Surgical Treatment of Retro-calcaneal Bursitis (Haglund’s Disease): Anatomy, Evaluation, Surgical Options, Complications, and Outcome

Vol 32| Issue 2 | July – Dec 2019 | page: 06-13 | Raju Karuppal, Anwar Marthya

Authors: Raju Karuppal [1], Anwar Marthya [2]

[1] Department Of Orthopaedics, Govt. Medical College, Kozhikode, Kerala, India.
[2] Department Of Orthopaedics, IQRAA International Hospital Calicut, Kerala, India.

Address of Correspondence

Dr. Raju Karuppal,
Govt. Medical College, Kozhikode, Kerala, India.


Retrocalcaneal bursitis (RCB) is one of the common causes of heel pain. Symptoms will often respond well to conventional methods of treatment. Those patients who do not respond to conventional treatment may get benefit from surgical interventions. An awareness of appropriate diagnostic and evaluation techniques are is necessary to diagnose and plan the surgical treatment. Initial treatments of Haglund’s disease include non-steroidal anti-inflammatory drugs, footwear modification, and various physiotherapeutic modalities. Bony hump excision is the main surgical treatment option, which can be performed by various surgical approaches, such as open procedures or by endoscopic techniques. Factors such as local skin condition, and medical co-morbidities which may retard tissue healing, possibilities of Achilles tendon damage, and post-operative pain must be considered while selecting the best surgical option. This article examines patient evaluation, surgical options, complications, and outcome of Haglund’s disease.
Keywords: Retrocalcaneal bursitis, Haglund’s disease, Calcaneal osteotomy, Endoscopic surgery, Complications.


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How to Cite this Article: Karuppal R, Marthya | A Surgical Treatment of Retro-calcaneal Bursitis (Haglund’s Disease): Anatomy, Evaluation, Surgical Options, Complications, and Outcome | Kerala Journal of Orthopaedics | July – Dec 2019 ; 32(2): 06-13 .

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PFNA-II for unstable intertrochanteric fractures – A prospective study on short term functional outcome

Vol 32| Issue 1 | Jan – June 2019 | page: 11-16 | Ranjith Parakkal Krishnan, Biju J Jacob, Dennis P Jose, Lazar J Chandy

Authors: Ranjith Parakkal Krishnan [¹], Biju J Jacob [¹], Dennis P Jose [¹], Lazar J Chandy [¹]

[1] Department Of Orthopaedics, V.P.S Lakeshore Hospital and Research Centre, Cochin, Kerala,

Address of Correspondence
Dr. Ranjith Parakkal Krishnan,
V.P.S Lakeshore Hospital and Research Centre, Cochin, Kerala, India.


Background: This study was carried out to study the short term functional outcome of proximal femoral nail
antirotation-II (PFNA-II) in the treatment of unstable intertrochanteric fractures.
Materials and Methods: This prospective study includes 20 cases of unstable intertrochanteric fractures in the age group between 55-94 years. The patients included in the study underwent fixation of intertrochanteric fractures using PFNA-II. The study was conducted in the department of Orthopaedics in an advanced trauma centre in Kerala between August 2018 and June 2019. Patients were followed up and assessed clinically and radiologically at regular intervals at 6 weeks, 3 months and 6 months. Functional score was assessed using Oxford Hip Score and Harris Hip Score.
Results: 20 patients were followed up for a period of 6 months. The minimum and maximum age was 55 and 95 years respectively. Majority of the fractures were fell into AO A2.2( 45.0%). The average OT time was 58.75 minutes with standard deviation 21.82. The average blood loss was minimal ( 124.5 ml). 85% cases could achieve good reduction. Good results were achieved in 75% (n=15) and Excellent results in 20% (n=4) cases according to Harris hip score. There was a significant relationship between Oxford hip score and fracture reduction (p-value is less than 0.05). There was a significant progress in Oxford hip score and Harris hip score 3 month and 6 months. No cases of cut out or breakage of the implant were noted during the study period. There was no major complication or mortality noted during the follow up period.
Conclusion: PFNA-II is ideal implant for fixation of unstable intertrochanteric fractures in elderly patients with less operative time, low complication rate and with a good clinical outcome. However it is important to follow proper
operative technique in order to attain fracture stability and to avoid major complications.
Keywords: Intertrochanteric fracture, Hip fracture, Intramedullary nail, PFNA-II, Complications, Harris hip score,
Oxford Hip Score, unstable.


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How to Cite this Article: Krishnan R P, Jacob B J, Jose D P, Chandy L J. “PFNA-II for unstable intertrochanteric fractures – A prospective study on short term functional outcome’’. Kerala Journal of Orthopaedics Jan-June 2019; 32(1): 11-16

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