Surgical treatment of plantar ulcers in leprosy

Plantar ulcers present a serious problem in the management of leprosy. After studying the mechanism of ulceration and the causes of their indolence, it appears that the treatment of the disease by antileprotic drugs is not sufficient. The underlying causes, such as anaesthesia, bony deformities and paralysis, should usually be treated by surgical means. Anaesthesia can be reversed by decompression of the posterior tibial nerve if this is done early. Deformities should be corrected by procedures on the soft tissues or bones, and chronic infection eradicated to prevent recurrence of the ulceration. A combination of procedures may sometimes be needed.