01871nas a2200325   4500000000100000008004100001260000900042653001000051653000900061653002200070653002800092653001700120653001100137653003100148653001100179653001200190653000900202653001600211653001400227653001600241100001300257700001100270700001500281700001300296245010600309300001000415490000800425520109800433022001401531       1989                            d  c198910aAdult10aAged10aAged, 80 and over10aArthropathy, Neurogenic10aCarpal Bones10aFemale10aHand Deformities, Acquired10aHumans10aleprosy10aMale10aMiddle Aged10aParalysis10aRadiography1 aNagano J1 aTada K1 aMasatomi T1 aHoribe S00aArthropathy of the wrist in leprosy--what changes are caused by long-standing peripheral nerve palsy?  a210-70 v1083 a<p>A radiographical screening study of 338 leprotic patients was performed. Clinically, according to a nerve score (NS) designed by us, 12.9% of 674 hands showed mild nerve palsy (NS 5 or 6), 75.9% moderate (NS 3 or 4), and 11.4% severe (NS less than 2). Twenty-nine hands of 26 patients (NS 4.2 on average) demonstrated abnormal changes of the wrist joint on radiographs. We classified them into four groups: (a) lunate collapse (four patients), (b) scaphoid nonunion (eight), (c) scaphoid cyst (three), and (d) trapezium OA (11). In the lunate collapse and the scaphoid nonunion groups, destructive and reconstructive changes as described by Eichenholtz were identified on plain film. These groups demonstrated remarkable instability of the stress and dynamic roentgenograms. In contrast, the scaphoid cyst and trapezium OA wrists showed neither fracture nor instability and fewer changes than the other two groups. We considered the destructive changes that had taken place in the lunate collapse and the scaphoid nonunion wrists to be neuroarthropathy due to long-standing nerve palsy.</p>  a0936-8051