Results of thumb correction in leprosy using different techniques.

Forty-four hands of 42 leprosy patients with paralysis of intrinsic muscles of the hand were treated by opponensplasty using ring finger superficialis (FDS4) or extensor indicis proprius (EIP). Superficialis tendon of middle finger was also used in these hands for lumbrical replacement by "direct lasso" operation. Low ulnar paralysis with Froment's sign was corrected by transfer of radial half of flexor pollicis longus (FPL) to extensor pollicis longus (EPL). Results of thumb correction were assessed and analysed in 37 hands of 35 patients. The mean follow-up period was 19 months. Best results were found with transfer of half FPL to EPL. Results of FDS transfer was good in 12 out of 16 manual workers. EIP transfer worked well, but the power of the thumb and patients' satisfaction was less.

Surgical correction of claw fingers in leprosy using flexor superficialis direct lasso procedure.

One tendon of Flexor digitorum superficialis split into two or four tails and each tail looped around the A1 pulley of one affected finger, was used for correcting intrinsic minus deformity of fingers in 144 patients. This operation has the advantage of retaining superficialis tendons of the other fingers for better power grip and avoiding swan-neck deformity. Satisfactory results were noticed in 81 of the 99 patients (82%) followed up. The remaining 18 patients showed a variety of problems such as swan neck/check rein deformity in the donor finger, skin contracture and recurrence of clawing.