RESUMO
The objective of this paper is to study the results and the factors that impact the results of claw hand surgery in leprosy. 110 patients who underwent claw hand correction between 2002 and 2006 were followed up and studied. Brand's criteria for objective assessment and a visual analog scale for subjective assessment were used. The factors studied were age, sex, clinical, duration of paralysis, long flexor tightness, degree of contracture and type of surgery. Objective assessment showed Excellent or Good results in 76.6%, Fair in 20% and Poor in 3.4%. Subjective assessment showed that 80.8% were fully satisfied or satisfied. Regression analysis showed that age, degree of contracture,duration of paralysis and long flexor contracture were seen as significant factors impacting results of claw hand correction.
Assuntos
Contratura/cirurgia , Articulações dos Dedos/cirurgia , Deformidades Adquiridas da Mão/cirurgia , Hanseníase/complicações , Paralisia/cirurgia , Neuropatias Ulnares/cirurgia , Adolescente , Adulto , Criança , Pré-Escolar , Contratura/etiologia , Contratura/fisiopatologia , Feminino , Articulações dos Dedos/fisiopatologia , Seguimentos , Deformidades Adquiridas da Mão/etiologia , Deformidades Adquiridas da Mão/fisiopatologia , Humanos , Lactente , Hanseníase/fisiopatologia , Masculino , Pessoa de Meia-Idade , Paralisia/etiologia , Paralisia/fisiopatologia , Análise de Regressão , Estudos Retrospectivos , Transferência Tendinosa/métodos , Resultado do Tratamento , Neuropatias Ulnares/etiologia , Adulto JovemRESUMO
The reactional states seen in lepromatous form (Erythema nodosum, exacerbation) and in interpolar forms (tuberculoid exacerbation and tuberculoid reversal reaction) result in cutaneous, nervous, lymphatic, visceral and polvarhritic acute manifestations. The successif relapses result in articular, cutaneous and muscular, sequelae of the hand but a paralysis of medial and ulnar nerves, often associated with leprosy, make them different from rheumatoid arthritis. They can be summarized thus: 1. Fexed claws hand associated with stiffness, erosions and sometimes subluxations of interphalangeal joints, mainly proximal and metacarpophalangeal joints. 2. Thickening and retractions of the skin of the dorsal face of the hand resulting in a trouble of the flexion of the fingers. 3. Contracture of the intrinsic muscles of the fingers and swan neck deformity. The treatment of the articular acute manifestations prevents the formation of sequelae. The authors study also the possibility of a curative treatment of fixed claws hand, skin retractions and swan neck deformities of the fingers, in hansenian patients