title: A novel modification of Bosworth's technique to repair zone I Achilles tendon ruptures.
abstract: BACKGROUND
  Zone I ruptures of the Achilles tendon and chronic ruptures in zone II with a gap of more than 6 cm are difficult to treat. We describe a technique that is very well suited to this type of rupture.
  
  
  METHODS
  Seventy-eight patients with chronic rupture of the Achilles tendon were operated on between January 1996 and December 2010. We used a modification of the Bosworth technique in which a strip of the gastrocnemius aponeurosis was taken, made into a tendon-like structure and passed through the calcaneum after making a drill hole; then it was sutured back to the proximal stump. The Leppilahti scoring system was used to evaluate these patients.
  
  
  RESULTS
  Sixty-two patients had excellent results, 8 had good results, 4 had fair results, 2 had poor results, and 2 were lost to follow-up at the end of 1 year. Nearly all patients resumed work at 6 months postoperatively, had normal walking and stair climbing, and regained normal dorsiflexion.
  
  
  CONCLUSIONS
  Our technique is ideally suited to zone I ruptures (where no distal stump is available for repair) and ruptures in zone II where end-to-end repair is not possible.
authors.affiliation: Chalmeda Anada Rao Institute of Medical Sciences, Bommakal, Karim nagar, Andhra Pradesh 505001, India. pavansarma007@gmail.com
authors.forename: Avadhanam
authors.initials: A
authors.lastname: Pavan Kumar
authors.forename: Raviprakash
authors.initials: R
authors.lastname: Shashikiran
authors.forename: Choulapalle
authors.initials: C
authors.lastname: Raghuram
mesh_terms: D000125:Achilles Tendon / Q000000981:diagnostic imaging / Q000293:injuries*; D000328:Adult; D000368:Aged; D002370:Casts, Surgical; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D012421:Rupture; D016896:Treatment Outcome; D014463:Ultrasonography