DOI: https://doi.org/10.36347/sasjs.2024.v10i08.011

Pages: 955-962

Background: Chronic Achilles tendon rupture in the watershed hypovascular region (zone II) makes end-to-end repair less feasible. Bosworth's technique, involving gastrocnemius-soleus turndown, was studied to determine its efficacy and functional outcome in repairing chronic tendon in zone II. Objective: To evaluate surgical reconstruction of old Tendo Achilles injury by Bosworth technique. Methods: This prospective study was carried out in Dhaka Medical College Hospital (DMCH) form July 2006 to December 2007. 20 cases were selected as non-randomized purposive sampling technique who came to the out patients department of DMCH. All cases were diagnosed as old neglected Tendo Achilles injury and treated by surgical reconstruction by Bosworth technique. Two cases were lost from follow up and discarded from the study. Finally the study was done on 18 patients. Results: The mean age of the patients was 31.7 years and the lowest and highest cases were 17 and 47 years respectively. The male female ratio was 5:1. One-third (33.3%) patients were day labourer, 22.2% service holders, 16.7% house wives and the rest 27.8% students. Two-Third of the patients (67%) had involvement of left Tendo Achilles and the rest (33%) had right Tendo Achilles. Nearly 40% of patients’ injury was caused by the overhanging edge of the toilet Pan, 27.8% by traumatic rupture, 11.1% assaulted by sharp weapon, another 11.1% by sharp edge of a metallic plate, 5.6% accidentally by sharp cutting knife and 5.5% by broken glass. The mediun level of injury was 3.5 cm above from the insertion of Tendo Achilles, while the lowest and highest level were 2.5 and 6 cm. Minimum delay from injury to operation was 6 weeks and maximum 32 weeks. 5 patients (27.8%) gained normal range of ankle movement, 6 patients (33.3%) decreased by 5° of unaffected side, 4 (22.2%) by 10° and 3 (16.7%) by more than 10⁰. Mean power of planter flexion, mean calf width and mean score to stand on tip toe on injured side relative ........