Haglund's syndrome is an abnormality of the bone and soft tissues in the foot. An enlargement of the bony section of the heel (where the Achilles tendon is inserted) triggers this condition.

• symptom includes insertional Achilles tendinopathy (IAT), The patient with HS often has a red, irritated, painful heel. And they often complain the enlargement of the posterior heel, which make it more difficult to footwear or sport

• Zadek described the Zadek Osteotomy option for the treatment of Haglund's syndrome This operation can change the calcaneus' anatomical length and elevate the distal insertion point of the Achilles tendon

  - It is a prospective case series study that will be done in Orthopedics and Traumatology department of Sohag university hospitals on patients suffering from Haglund's syndrome and treated by Zadek osteotomy

• This study aims to evaluate short term clinical, radiological and functional outcomes of Zadek osteotomy for treatment of Haglund's syndrome

Introduction

• In 1928, Patrick Haglund described the Haglund syndrome firstly. Haglund's syndrome is an abnormality of the bone and soft tissues in the foot. An enlargement of the bony section of the heel (where the Achilles tendon is inserted) triggers this condition. The soft tissue near the back of the heel can become irritated when the large, bony lump rubs against rigid shoes.
• symptom includes insertional Achilles tendinopathy (IAT), The patient with HS often has a red, irritated, painful heel. And they often complain the enlargement of the posterior heel, which make it more difficult to footwear or sport.
• There are many conservative treatment options to treat it, which contains rest, activity modification, ice, or footwear modification.
• When these treatment for more than 6 months has failed, surgical options will be considered.
• Common surgical methods, including Haglund deformity debridement, endoscopic calcaneoplasty, and Zadek osteotomy (ZO).
• Zadek described the ZO option for the treatment of HS firstly. It was later modified by Keck and ZO is a dorsal closing wedge calcaneal osteotomy that allows the tuberosity of Haglund deformity to be brought forward. This operation can change the calcaneus' anatomical length and elevate the distal insertion point of the AT.

Aim of the work

• This study aims to evaluate short term clinical, radiological and functional outcomes of Zadek osteotomy for treatment of Haglund's syndrome.

Patients and Methods

• It is a prospective case series study that will be done in Orthopedics and Traumatology department of Sohag university hospitals on patients suffering from Haglund's syndrome and treated by Zadek osteotomy
• We are aiming in this study to include patients within period between 4/2025 to 10/2025

Inclusion Criteria:

• patients over 18 years of age and less than 60 Yrs
• All patients had at least six months of conservative treatment

Exclusion Criteria:

1. patients below 18 years of age and more than 60 Yrs
2. patients of Haglund's syndrome with AT rupture or degeneration
3. uncontrolled diabetic patients with or without neuropathic joint destruction,
4. Infection such as osteomyelitis.
5. Charcot joint.
6. Peripheral vascular disease

Patients attending and treating in Sohag University Hospital in Upper Egypt