Assuntos
Desbridamento/métodos , Larva , Ferimentos e Lesões/terapia , Animais , Humanos , Resultado do Tratamento , CicatrizaçãoRESUMO
The loss of sensation in skin lesions, and in a palm or sole that has been innervated by peripheral nerve trunks, is characteristic of leprosy. Detection of early nerve trunk involvement depends on demonstrating sensory loss. Newer developments in neurological sciences have made fresh interpretations of the observed sensory abnormalities in leprosy-affected persons possible. Some of these observations are described in this review, and their implications discussed.
Assuntos
Hanseníase/fisiopatologia , Sensação/fisiologia , HumanosRESUMO
In 12 patients, the extensor carpi radialis longus muscle tendon unit was elongated using the radial half of the parent tendon so that it could reach the site of new insertion, the A1-A2 pulley of flexor sheath or lateral bands, after routing the transfer through the carpal tunnel. The tendon was of appropriate thickness and could be split into two halves to be used as a graft. Further splitting of the tendon into four tails was possible. The transferred slips retained adequate strength to activate the fingers after the operation. It is suggested that splitting of the extensor carpi radialis longus tendon to use one half as a tendon graft be considered in patients in whom extensor carpi radialis longus transfer is planned to correct finger clawing. This technique is simple, needs minor modification in the sequence of operative steps, reduces operating time, and saves the patient from postoperative discomfort, muscle herniation, and scarring at the donor site (usually the thigh).
Assuntos
Dedos/cirurgia , Deformidades Adquiridas da Mão/cirurgia , Transferência Tendinosa/métodos , Deformidades Adquiridas da Mão/etiologia , Humanos , Hanseníase/complicaçõesRESUMO
In 12 patients, the extensor carpi radialis longus muscle tendon unit was elongated using the radial half of the parent tendon so that it could reach the site of new insertion, the A1-A2 pulley of flexor sheath or lateral bands, after routing the transfer through the carpal tunnel. The tendon was of appropriate thickness and could be split into two halves to be used as a graft. Further splitting of the tendon into four tails was possible. The transferred slips retained adequate strength to activate the fingers after the operation. It is suggested that splitting of the extensor carpi radialis longus tendon to use one half as a tendon graft be considered in patients in whom extensor carpi radialis longus transfer is planned to correct finger clawing. This technique is simple, needs minor modification in the sequence of operative steps, reduces operating time, and saves the patient from postoperative discomfort, muscle herniation, and scarring at the donor site (usually the thigh).
Assuntos
Humanos , Dedos/cirurgia , Deformidades Adquiridas da Mão/cirurgia , Deformidades Adquiridas da Mão/etiologia , Hanseníase/complicações , Transferência Tendinosa/métodosRESUMO
The paper describes unfavourable outcomes of some of the commonly performed surgical procedures in leprosy affected persons and the underlying causes. An awareness about unfavourable outcomes of surgery is helpful to the beginners because they can anticipate the problems and take appropriate measures to prevent that and failing which prepare themselves to face and sort that out. Careful pre-operative evaluation of the patient is an important first step.
