Results of surgical procedures for the correction of foot-drop and of lagophthalmus due to leprosy.

Leprosy mutilations of the muscles and skeleton can be relieved by reconstructive surgery, but evaluation of the results of these operations is seldom undertaken. Between 1975 and 1984, 59 leprosy patients were operated on at the Marie Adelaide Leprosy Centre, Karachi, Pakistan, for lagophthalmus with the transposition of the posterior tibial muscle. We were able to re-examine 39 patients: tibialis posterior transposition was performed 25 times, and temporalis transposition was carried out 33 times; 18 of the 25 patients with the tibialis posterior transposition were pleased with the result, 7 were not: 21 patients could extend their feet above the neutral position; 24 of the patients with the temporalis transposition were satisfied, 9 were not: complete closure was demonstrated in 21 eyes; Persistent corneal damage was noted in 15 eyes; 12 of the 23 male patients cared for themselves, 16 lived with their families; 7 of the 8 female patients lived with their families. The results of the rehabilitation, in relation to the degree of mutilation, are considered satisfactory for a developing country. These surgical procedures give a good result, provided they are followed by intensive physiotherapy.

[New technic of palliative intervention in paralysis of the intrinsic muscles of the hand (cubital paralysis in Hansen's disease)]. / Nouvelle technique d'intervention palliative dans la paralysie des muscles intrinsèques de la main (paralysie cubitale dans la maladie de Hansen).

On a single poster, drawings explain a surgical technique we performed for some time in the Institut Marchoux on souple clawed fingers in hansenian ulnar palsy. Sketches at first recall anatomy physiopathogeny's principles and hence usual operations yet performed, then the main steps of our method. Its qualities are simplicity, speediness and compatibility with other treatments. In spite of being too recent for a proper view, results are already hopeful.

The results of lumbrical replacement by extensor to flexor many tail operation--a retrospective study.

A follow-up study was carried out on sixty one (61) leprosy patients who had extensor to Flexor Many tail surgery at Schieffelin Leprosy Research and Training Centre, Karigiri from 1975 to 1976. After analysing the data, it was noticed that the amount of clawing reduced considerably. Secondly the over all assessment was good for 70% of the hands. But the deformities such as intrinsic plus, deviation of fingers, M.P. extension, Limitation, I.P. Flexion Limitation and loss of fingers showed an increase in number post-operatively when compared to the pre-operative deformities. The reasons for these effects are discussed in this paper.

Clawfinger correction: results of extensor-flexor many tailed operation.

The patient with paralytic clawfingers is greatly handicapped. This is especially true for the leprosy patient who needs his hands to earn a living. The inability to 'reach out' with the fingers is the most serious functional loss in an ulnar palsy. This study is a follow up of 155 hands whereby the extensor carpi radialis longus was employed to substitute for this lumbrical-interosseus function. The best results were obtained in hands with full assisted extension. Retropulsion of the metacarpal arch occurred in all hands with total loss of ulnar function.

Opponensplasty in intrinsic-muscle paralysis of the thumb in leprosy.

For eighty-six cases of leprous paralysis of the intrinsic muscles of the hand, a modified Bunnell opponensplasty (transfer of a finger flexor) was done. Good results were seen in eighteen and fair results in sixty-three. The five poor results occurred because of infection, weakness, or deformity. Adjuvant procedures, as needed, were interphalangeal arthrodeis of the thumb, capsulorrhaphy of the wrist, and additional tendon transfers.