The calcaneal tuberosity is the posterior projection of the calcaneus that serves as the insertion of the Achilles tendon (at its posterosuperior surface) and the origin of the plantar intrinsic muscles (at its plantar surface). The retroCalcaneal bursa lies between the superior tuberosity and the Achilles tendon. Haglund's deformity (posterosuperior calcaneal prominience) causes retrocalcaneal bursitis and insertional Achilles pathology.
Haglund's deformity — the posterosuperior calcaneal bony prominence — produces retrocalcaneal bursitis from shoe counter impingement. Calcaneal osteotomy removing the posterosuperior prominence (Zadek osteotomy) combined with Achilles detachment, intratendinous debridement, and reattachment is the surgical treatment for refractory insertional Achilles tendinopathy.
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