Reconstructive surgical correction of ulnar nerve paralytic claw fingers in Hansen’s disease patients by Lasso procedure

Abstract

Introduction: Hansen's disease is a chronic infectious granulomatous disease caused by Mycobacterium leprae and the organisms affect mainly peripheral nerves and skin. The deformities seen in Hansen's disease may result from the disease process or paralysis of some muscles due to damage to peripheral nerve trunk or injuries/infection to hands or feet. Reconstructive surgery for Hansen's disease patients is one of the ways of eliminating stigma associated with deformities and it also helps in restoring patient's ability to carry out some basic functions. Case Series: Four cases of claw fingers resulting from ulnar nerve paralysis were considered in this study. Two of them dropped out of school because of the deformities. All of the patients considered in this study had mobile claw fingers and three of them had associated contracture. The contractures were corrected with serial manipulation and casting with Plaster of Paris before commencement of preoperative physiotherapy. They were operated using Zancolli Lasso procedure under local anesthetics as regional block and had an uneventful postoperative period. All of them had satisfactory correction of their deformities. Conclusion: Reconstructive surgery for Hansen's disease patients is one of the ways of eliminating stigma associated with deformities and it also helps in restoring patient's ability to carry out some basic functions. The selection criteria for optimal outcome in reconstructive surgery for Hansen's disease patients must be strictly followed in order to have a good outcome.