BOSWORTH TECHNIQUE FOR SURGICAL-TREATMENT OF ACHILLES-TENDON RUPTURES- A 42 CASE REPORT

Purpose of the study There is no consensus on the treatment of acute r uptures of the Achilles tendon. We have chosen surgical technique with early muscle stimulation, This study analyses possibilities of functi onal recovery and complications in Athletes. Materials and methods Bet ween 1983 and 1994, we treated surgically 42 Athletes who had Achilles tendon ruptures with early musculo-tendinous stimulation. The 39 male and 4 female patients had a mean age of 41 years (range, 15 to 70). W e have always used Bosworth's technique with gastrocnemius flap proced ure. Immediately after surgery, weightbearing with below-the-knee cast was initiated for 6 weeks followed by rehabilitation. Results There w as no local major complication, deep vein thrombosis or pulmonary embo lism. Only one patient suffered from a traumatic rerupture one month a fter surgery. Mean value of the calf atrophy was less than 1 cm. 93 pe r cent of patients returned to previous activity levels and 78.5 per c ent of patients returned to their usual sport activity. Discussion Lik e this study recent results confirm the low complication and recurrenc e rate of the surgical treatment. Percutaneous technique and conservat ive treatments seem to be worse for rerupture and sportive functional recovery. Early muscle stimulation decrease morbidity and calf atrophy . Our protocol with weightbearing in ankle neutral position reduces ca lf atrophy. Conclusion A rigid and stable reconstruction, allowing ear ly weightbearing without equinus position seems to be a rational treat ment for Achilles tendon rupture in athletes.