[What was found in deformities of leprosy patients from the view-point of orthopedics?].

No more deformities which are the cause of social stigma by early detection and chemotherapy! Let patients learn how to avoid getting deformed to keep normal ADL & QOL. Fight against the nerve damage and stop the progressive deformities by organizing the team approach. Instead of intense efforts of taking care by well organized team work, deformities are resulted inevitably in some cases. Let their deformities be out of the way of their keeping normal community lives without any prejudice, respecting their human rights and dignity.

Cost-effective footwear for leprosy control programmes: a study in rural Ethiopia.

A randomized, controlled trial of commercially available canvas shoes was carried out in a rural area of Ethiopia. Subjects with deformed and anaesthetic feet, most with ulceration, were given either canvas shoes or plastazote/moulded shoes and followed up for one year. Seventy-five percent of subjects with ulcers who used canvas shoes had no ulcer at the end of the study, while no significant change was noted in the plastazote group. The durability and acceptability of the shoes were also examined. Clients in remote areas who have no access to an orthopaedic workshop, but who have anaesthetic feet, with or without deformity, should have access to canvas shoes with an MCR insole. Two pairs are needed per year at a cost of US$6.7 per pair.

A preliminary objective evaluation of leprosy footwear using in-shoe pressure measurement.

The primary function of leprosy shoes, insoles and podiatric orthoses is to provide an underfoot environment capable of distributing the inevitable vertical forces, so reducing areas of peak pressure and ideally the period through which they are applied. Many patients with Hansen's disease have both skeletal deformity and anesthetised feet and the presence of high plantar pressures is the key reason for foot ulceration. This objective investigation using in-shoe dynamic pressure measurements showed that the addition of a shank to control insole rigidity reduced the overall peak pressures under the foot. When a deep canvas shoe was used to test single- and double-thickness insoles of two different types of material it was found in each case that the double-thickness mode was advantageous overall. Microcellular rubber insoles in two types of leprosy shoe were replaced by the polymer Poron. The Poron proved to be superior to both microcellular rubbers. The peak pressure and pressure-time integral should be considered as complimentary variables when determining the efficacy of footwear.

[Vicissitudes of treating leprosy handicaps in Kapolowé, Zaïre]. / Vicissitudes du traitement des handicaps hanséniens à Kapolowé (Zaïre).

In 1990 Kapolowé was, without a doubt, the site of the only surgical centre in Zaire dealing with handicaps which developed in as an after-effect of leprosy. It would be useful to explain the hazards involved in such a venture for reasons which do not pertain to medicine but, rather, to particularly trying socio-political circumstances. The best surgical expertise was thrown out for political reasons. Insecurity and economic hardships practically halted movement and, consequently, the wider application of such expertise. During a mission in 1994, there was a partial resumption of activities. The surgical team was reinstalled and made operational. It had been possible to state that multidrug therapy (MDT) had always ensured that the disabled leprosy patients, living in groups, and treated before 1990 under regular supervision, did not experience serious relapses. That fact corroborates earlier information relating particularly to surgical decompression. Although most of them were able to resume a certain measure of professional activity, social factors must still be borne in mind and the concept of partial permanent disability must be applied.

The aims and methods of physiotherapy in field conditions in the National Leprosy Control Programme.

The main aim of physiotherapy in field conditions in National Leprosy Control Programme is preventive rehabilitation which can be achieved by systematic recording and reporting on the individual deformity status of all the patients followed by standardized methods of preventive management at peripheral clinics run single handedly by para-medical workers. The few patients in acute conditions and still fewer in need of surgical rehabilitation etc, require special reporting and special attention afforded by collective efforts of all the categories of workers engaged at a control unit. The system of reporting on deformity based on the W.H.O. Classification of deformities (1960) and of preventive management introduced at the Leprosy Control Unit, West, Hyderabad is found to be appropriate, statistically appreciable and sound in principle. The idea to avoid surgeon's knife and sophisticated methods of physical rehabilitation in field work as much as possible, and yet achieve the objectives of preventive rehabilitation of leprosy patients is feasible and successfully maintainable.

Rehabilitation of the paralytic drop foot in Hansens disease

Drop foot, resulting from paralysis of the deep branch of the common peroneal nerve, is a frequent complication of patients with Hansen's disease(leprosy).

Rehabilitacion del enfermo com lepra

En el presente trabajo, después de una breve introduccion sobre la rehabilitacion del enfermo con lepra, se hace referencia a generalidades de la enfermedad, como: origen de la enfermedad en México, número de enfermos en la Republica Mexicana (se consideran de 50 a 60,000), clasificacion, y dos grupos: indeterminado y dimorfo. Se estudiam las incapacidades físicas y psicosociales que la enfermedad produce a las personas afectadas; las físicas de localizacion en las manos, pies y cara, principalmente y las incapacidades psicosociales desde el punto de vista de como afectam a la persona y sus familiares en los diferentes aspectos: psiquico, economico y social