How is the Surgery Performed?

There are two different problems that cause heel bumps and each benefits from different operations.

If there is a lump on the back of the calcaneus bone - a Haglund deformity - then this can be removed with surgery with good results. The incision is made on the outer side of the Achilles Tendon.

If the lump is caused by the deposition of calcium in the Achilles Tendon, then two operations can be performed depending on the severity. Both are performed by an incision in the line of the Achilles Tendon.

If the Achilles Tendon attachment is completely involved then the damaged tissue is excised and the tendon is reattached to the heel bone. This is done with special bone rawl plugs that secure the tendon. This requires prolonged rehabilitation, with six weeks in plaster and six weeks in an aircast plastic boot.

If the tendon is only partly involved, it may be possible to remove the hard calcified tissue without detaching the tendon. It is possible to weight bear after the operation without the use of a plaster cast.

The type of operation you require can only be determined at the time of surgery. You need to be prepared to have either, depending on what is found.

Surgery is carried out under general anaesthetic, but can be carried out with local anaesthetic injections behind the knee or around the ankle. The injections are normally given while you are asleep for your comfort. They can give good pain relief for the first day after the operation. You can go home the same day in the evening.

Risks of Surgery

Bleeding, infection, poor bone healing, poor skin healing, injury to tendons, injury to nerves, recurrence, and a need for further surgery.

There is a small risk of blood clots in the legs or lungs (DVT and PE), and there are also risks from anaesthesia - the process of being put to sleep for your operation.

Risks of Anaesthesia

The injection behind your knee is given using an ultrasound machine to guide the needle. There is a less than 1% chance of injury to the nerve. General anaesthetic also carries risks. These risks are proportional to your general health. You will need to be assessed for your fitness for surgery and an Anaesthetist will be able to advise you on your individual risk.

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