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All Journal Indonesian Journal of Global Health research
Kusuman, Kevin
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Education Health Professions Languange, Linguistic, Communication & Media Nursing Public Health

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Combination of Zadek Osteotomy and Achilles Tendon Re-Attachment in Severe Haglund Deformity: A Case Report Kusuman, Kevin; Subawa, I Wayan; Ismail, Mohamad Dimas
Indonesian Journal of Global Health Research Vol 7 No 2 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i2.5679

Abstract

Haglund deformity refers to a bony exostosis on the posterosuperior aspect of the calcaneus, often causing retrocalcaneal bursitis and Achilles tendinopathy. Conservative treatments, including physiotherapy and medication, may not relieve symptoms in severe cases. Surgical intervention is indicated when non-operative treatments fail. This report highlights a case of severe Haglund deformity managed with Zadek osteotomy and Achilles tendon re-attachment.Case Presentation: A 45-year-old female presented with 2 months of severe right heel pain and a 2-year history of a prominent bump. Physical therapy yielded no improvement. Clinical and radiographic evaluation confirmed Haglund deformity with insertional Achilles tendinopathy. Surgical treatment involved Zadek osteotomy, fixation with screws, and Achilles tendon re-attachment using a suture anchor. The combined approach addressed both the bony deformity and tendon degeneration. Post-operative outcomes showed significant improvement. At the 3-month follow-up, the patients Visual Analog Scale (VAS) pain score decreased from 7/10 to 1/10, and the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot score improved from 55 to 90. The range of motion was near normal, and functional recovery was excellent. This case demonstrates the effectiveness of combining Zadek osteotomy and Achilles tendon re-attachment for treating severe Haglund deformity. This approach provided significant pain relief and functional recovery, making it a viable option for patients with similar conditions refractory to conservative management.
Retrograde Insertion of An Antegrade Intramedullary Femoral Nail for Treatment of A Pathological Femoral Shaft Fracture in A Patient with Metastatic Bone Disease Kusuman, Kevin; Wiratnaya, I Gede Eka
Indonesian Journal of Global Health Research Vol 6 No 6 (2024): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v6i6.4420

Abstract

Pathological fractures of the femur due to metastatic bone disease are challenging to treat, requiring stabilization to improve patient quality of life. Intramedullary nailing is a common treatment method, typically performed in an antegrade manner. However, in cases where antegrade insertion is difficult, retrograde techniques may be considered. We report a case of a 68-year-old female with metastatic breast cancer, presenting with a pathological fracture of the femoral shaft. Due to a large proximal femoral lesion and limited access for traditional antegrade femoral nail insertion, a retrograde approach was chosen. A standard antegrade intramedullary femoral nail was inserted retrograde through the distal femur. The procedure was successful, providing immediate stability and pain relief. Postoperatively, the patient was able to ambulate with assistance and was discharged for further oncological management. The retrograde insertion of an antegrade femoral nail offers an alternative in cases where antegrade insertion is not feasible due to proximal femoral involvement. While antegrade nailing is traditionally preferred, retrograde techniques offer comparable stability and functional outcomes, especially in metastatic bone disease where palliative treatment is a priority. This approach allows for reduced surgical trauma and faster recovery. Retrograde insertion of an antegrade femoral nail can be a viable option for stabilizing pathological femoral shaft fractures in patients with metastatic bone disease. It provides a feasible alternative when conventional approaches are not suitable, improving patient outcomes and quality of life.
Co-Authors Eka Wiratnaya I Wayan Subawa Ismail, Mohamad Dimas