• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.123-129
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• 2007

Purpose: The aim of this study was to analyze radiological change of Kager's triangle in patients with retrocalcaneal disorders. Materials and Methods: Areas of Kager's triangle and calcaneus were calculated with Heron's Formula. Average of area ratio (area of Kager's triangle / area of calcaneus) was calculated for comparison and analysis, according to disease activity and aging process. One-tailed Z-test was done with the average of area ratio. Results: Average of area ratio (area of Kager's trianlge / area of calcaneous) tends to decrease according to aging process and disease existence. Conclusion: Because area of Kager's triangle in patients with retrocalcaneal disorders tends to change according to disease activity and aging process, we should consider clinical correlation between the anatomical structure of Kager's triangle and retrocalcaneal symptoms.

• Journal of Korean Foot and Ankle Society
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• v.12 no.2
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• pp.197-202
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• 2008

Purpose: Haglund's disease represents a painful heel caused by mechanically induced inflammation of the retrocalcaneal bursa and insertional Achilles tendinosis may coexist. Traditional open surgery can cause complications such as skin breakdown, painful scar and altered sensation around the heel. Endoscopic treatment offers the advantages that are related to minimally invasive procedure and we evaluate the clinical results and operative techniques of endoscopic decompression of retrocalcaneal space for Haglund's disease. Materials and Methods: Our retrospective study included seven heels in six consecutive patients for which nonoperative treatment had failed and endoscopic decompression was performed. The mean age was forty-one years (range, 28 to 53 years). All of the patients had typical complaints of inflammation of the retrocalcaneal bursa and Fowler-Philip angle of more than $75^{\circ}$ and positive parallel pitch lines were present on the lateral calcaneal radiograph. The endoscopic procedure consists of the resection of inflamed retrocalcaneal bursa and enough bone to prevent impingement of the bursa between the calcaneus and Achilles tendon. All patients were evaluated with radiologic angle, visual analogue scale (VAS) for pain and Ogilvie-Harris functional score. The mean follow-up was 18 months (range, 15 to 21 months). Results: The mean operation time was 61 minutes (range, 50 to 85 minutes). VAS for pain and Fowler-Philip angle were decreased from preoperative 8.7 and $82^{\circ}$ to postoperative 2.3 and $57^{\circ}$, respectively. One patient with ankylosing spondylitis had a fair result, 2 patients had good results and the remaining 3 patients had excellent results according to Ogilvie-Harris functional score. There were no surgical complications such as infection, Achilles tendon avulsion or abnormal heel sensation. Conclusion: The endoscopic decompression for Haglund's disease was demonstrated to have several advantages including low morbidity, allowance of functional rehabilitation, short recovery time and quick sports resumption. However a comparative study is needed to determine the value of endoscopic decompression and particular caution should be exerted for the enthesiopathy.

• Journal of Korean Foot and Ankle Society
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• v.4 no.1
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• pp.48-54
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• 2000

Haglund's syndrome produces retrocalcaneal bursitis or achilles tendinitis due to impingement of posterior superior bursal projection of calcaneus on insertional fibers of achilles tendon. Haglund's syndrome has been mainly associated with wearing rigid counter shoes and with athletes. We experienced three case of late sequelae of secondary Haglund's syndrome after malunion of tongue type calcaneus fracture. It is to be the first description of secondary Haglund's syndrome after calcaneus malunion and also the first report as the late complication of calcaneus fractures. Three cases were all tongue type intraarticular fractures and were treated with $45^{\circ}$ superior angle resection of superior calcaneal tuberosity. Clinical results by modified Rowe score were excellent with complete pain relief for all three cases.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.2
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• pp.102-105
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• 2012

Schwannoma is a common peripheral nerve tumor that mainly occur at head and neck, flexor muscle of upper, and lower extrimity. In posterior tibial nerve schwannoma, diagnosis is difficult, since physicians often consider achilles tendinitis, posterior impingement syndrome, retrocalcaneal bursitis, or injury of the flexor tendons, as the primary cause in patients with posterior ankle pain. Ultrasonogram may be a simple tool to differentiate such various diseases. The authors report a case of posterior tibial nerve schwannoma diagnosed with ultrasonogram, which was initially misunderstood as achilles tendinitis.