Abstract
Background: Most ruptures of the Achilles tendon occur at the watershed area which is about 2 to 6 cm proximal to insertion of the tendon. There are many techniques of repair like using tendon transfer, autograft or synthetic ligament. Bosworth has described a technique of sural triceps aponeurosis turndown. The study was conducted with the objective to describe the effectiveness and functional outcome after Bosworth procedure in chronic ruptures in zone II in cases where end-to-end repair can’t be done. Material and Methods: The study consisted of a total 20 patients. Positive Thompson test was elicited in all patients. Bosworth technique was used in for repair in all patients. The functional outcome was assessed at 1 month, 6-month and 1-year follow-up visits using the clinical scoring method described by Leppilahti et al. Results: All patients resumed work at 6 months postoperatively. Almost all patients had normal walking and stair climbing. The range of ankle motion showed significant improvement postoperatively. Conclusion: Bosworth repair for chronic neglected Achilles tendon ruture is still a good method for achieving better functional outcomes for ankle for ruptures of Achilles tendon in zone 2, where more than 2 cm distal stump is available.
Highlights
Though Achilles tendon is the strongest, largest, and thickest tendon in the body, yet it is the most frequently ruptured tendon [1,2]
Background: Most ruptures of the Achilles tendon occur at the watershed area which is about 2 to 6 cm proximal to insertion of the tendon
Bosworth has described a technique of sural triceps aponeurosis turndown
Summary
Though Achilles tendon is the strongest, largest, and thickest tendon in the body, yet it is the most frequently ruptured tendon [1,2]. There are many techniques of repair like using tendon transfer [6,7,8], autograft [9,10,11,12] or synthetic ligament [13,14]. This includes end to end repair of the tendon like in v-y plasty; the one described by Bosworth and others like Coughlin of gastrocnemius soleus complex “turndown” of proximal achilles tendon tissue [10] ; local tendon transfer that of peroneus brevis (pb)[15] or flexor hallucis longus (FHL) tendon or can use synthetic grafts like carbon fiber composites, polyglycol threads, and polyester mesh. The study was conducted with the objective to describe the effectiveness and functional outcome after Bosworth procedure in chronic ruptures in zone II in cases where end-to-end repair can’t be done. Plain X-rays showed Achilles tendon rupture by the gap between the tendon ends
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