Reconstruction of neglected tendo-Achilles tears using the technique of gastrocnemius-soleus turndown graft: A case series

Abstract

Chronic, neglected Achilles tendon ruptures cause a significant impairment of ankle function due to weakness of active plantar flexion which is required in performing day-to-day activities such as walking and climbing stairs. The causes range from trivial trauma like a slip and fall to high impact injuries. Predisposing factors include a history of previous steroid injections, advanced age, and vigorous sporting activities. Tears involving the zone 2, where vascularity is compromised, pose a challenge to surgeons, as the repair is often jeopardized by wound complications and re-ruptures. Of the several techniques described, we have used the Bosworth's technique of gastrocnemius-soleus turndown to reconstruct defects in this zone in 16 patients and have achieved a satisfactory functional outcome at 1 year with a relatively low incidence of complications. However, this technique requires the presence of an intact distal stump of the tendon of adequate length, the absence of which precludes the use of this method.