Keck and Kelly procedure is indicated for which condition?

Keck and Kelly procedure is indicated for which condition?

• A. Haglund deformity
• B. Plantar fasciitis
• C. Tarsal tunnel syndrome
• D. Retrocalcaneal exostosis

Answer: (D)

The main concept here is addressing a posterior calcaneal prominence that irritates the Achilles tendon and the retrocalcaneal bursa. The Keck and Kelly procedure is a posterior calcaneal exostectomy with bursectomy, performed to remove the retrocalcaneal exostosis (the bony bump) and decompress the area where the Achilles tendon insertions and the retrocalcaneal bursa lie. By shaving off the exostosis, you eliminate the impingement that causes pain, swelling, and bursal irritation commonly seen with Haglund deformity. This targeted removal is why the procedure is best associated with retrocalcaneal exostosis. It is not a treatment for plantar fasciitis, which involves the plantar fascia, nor for tarsal tunnel syndrome, which is about nerve compression. While Haglund deformity often describes the same posterior calcaneal prominence, the explicit indication is the retrocalcaneal exostosis causing impingement and bursitis, which the Keck and Kelly approach directly addresses.

The main concept here is addressing a posterior calcaneal prominence that irritates the Achilles tendon and the retrocalcaneal bursa. The Keck and Kelly procedure is a posterior calcaneal exostectomy with bursectomy, performed to remove the retrocalcaneal exostosis (the bony bump) and decompress the area where the Achilles tendon insertions and the retrocalcaneal bursa lie. By shaving off the exostosis, you eliminate the impingement that causes pain, swelling, and bursal irritation commonly seen with Haglund deformity.

This targeted removal is why the procedure is best associated with retrocalcaneal exostosis. It is not a treatment for plantar fasciitis, which involves the plantar fascia, nor for tarsal tunnel syndrome, which is about nerve compression. While Haglund deformity often describes the same posterior calcaneal prominence, the explicit indication is the retrocalcaneal exostosis causing impingement and bursitis, which the Keck and Kelly approach directly addresses.