الفهرس 
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Abstract
Abstract Haglund`s deformity is one among many causes of posterior heel pain. It was first described by Patrick Haglund in 1928 as a posterosuperior calcaneal prominence, anterior to the insertion of tendoachilles, causing mechanical compression over the local soft tissues, associated with wearing low back foot wear with a rigid counter. the presence of this prominence predisposes to Haglund`s disease, a triad of retrocalcaneal bursitis, insertional Achilles tendinopathy, and a painful pump bump. Patient usually complains of posterior heel pain and examination reveal painful thickening of the soft tissue of the hindfoot appearing as a ”bump”, with tenderness on either or both sides of the tendoachilles. Haglund`s disease is often bilateral, mostly at the end of 2nd or the 3rd decade, mainly in females. The primary measures for treatment of Haglunds disease are Nonsteroidal Anti Inflammatory drugs (NSAIDS), modified foot wear (heel lifts, soft soles, or sleeves), physical therapy, extracorporeal shock wave therapy. Surgical treatment is usually reserved for those who completely fail conservative therapy.Various surgical options available for patients with Haglund’s disease who do not respond adequately to nonoperative therapy exist, including both open techniques with various approaches and endoscopic techniques. Open procedures are advantageous as they provide appropriate exposure and allow adequate removal of inflamed tissue and the calcaneal prominence.The Zadek`s osteotomy, first described by Zadek in 1939 for the treatment of Haglund`s disease, The goal of the procedure is to remove a dorsal wedge from the calcaneus, allowing the calcaneal tuberosity to rotate anteriorly. The dorsal base of the wedge is about 1 cm.The aim of this study is to assess the clinical outcomes of Zadek osteotomy in patients with Haglund`s disease after conservative treatment. This is a prospective study of 10 patients admitted to Mansoura University Hospital diagnosed with Haglund`s for 1 year period from January 2018 to January 2019. The mean age of the patients (six females and four males) ranged between 38 and 63 years with a mean age of 52.8 years.Preoperative clinical and radiological assessment using plain X-ray and MRI were done. Postoperatively, patients were encouraged to perform elevation of the foot for the first week. The AOFAS ankle-hindfoot scale was employed to evaluate the patient`s outcome. All patients were followed up in the outpatient clinic for at least 6 months. Any complication was reported. Conventional footwear was not allowed to be worn during the first 8 weeks, and physical activities were not allowed before 3 months.Preoperatively, the mean AOFAS score ranged from 40 to 65 points at a mean of 45.1 points. Postoperatively, it ranged from 83 to 100 points at a mean of 93.2 points. Statistically, there was a high significant difference between preoperative and postoperative state regarding AOFAS changes. In our study, return to sport activities ranged between 6 and 12 with mean ± SD of 8.4 ± 1.8. Postoperatively, our study noted superficial wound infection in 3 patients (30%), delayed union was noted in 2 patients (20%) and nonunion and DVT were noted in 2 patients; one for each complication (10%).