For patients with refractory retrocalcaneal bursitis (Haglund's syndrome), the most effective surgical approach has not been defined. We asked whether patients undergoing the tendon-splitting approach and the lateral approach would have comparably effective relief of pain for both types of calcaneal ostectomies. We retrospectively reviewed 30 patients (31 feet) who underwent the tendon-splitting approach and compared their results with 32 previous patients (35 feet) who had a lateral incision. Minimum followup was 12 months (mean, 16 months; range, 12-23 months) for the tendon-splitting group and 15 months (mean, 51 months; range, 15-109 months) for the lateral group. The mean American Orthopaedic Foot and Ankle Society score improved from 43 points preoperatively to 81 points (range, 8-100 points) postoperatively in the tendon-splitting group and from 54 points to 86 points (range, 55-100 points) in the lateral group. The mean physical component score of the Short Form-36, version 2, at followup was 52 (range, 22-61) in the tendon-splitting group and 49 (range, 34-63) in the lateral group. The median return to normal function was 4.1 months (range, 3-13 months) in the tendon-splitting group and 6.4 months (range, 4-20 months) in the lateral group. Both approaches to calcaneal ostectomy provided symptomatic pain relief. However, patients in the tendon-splitting group returned to normal function quicker than patients in the lateral group. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
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