Evaluation of the Functional Outcome After Bosworth Technique for Neglected Achilles Tendon Rupture - A Clinical Study

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.

Repair of chronic Achilles tendon rupture using Bosworth’s technique

“…25 Our study utilized the Bosworth's technique for repair of neglected Achilles tendon tear in zone II and achieved good functional outcomes as 4/5 had excellent results and 1 patient had good functional outcome. Results are in cohesion with studies conducted by Ahmed et al, 18 Agarwal et al 26 No dreaded postoperative complication were seen in our study although a number of studies have reported variable rates of infection, wound dehiscence. 27 Ascertaining the exact size of the graft to restore the length of tendon can be tricky using the Bosworth's technique.…”