02019nas a2200337   4500000000100000008004100001260001700042653001500059653001000074653002800084653001800112653001100130653001200141653002500153653001400178653003900192653002800231653001600259653001000275653002300285100001700308700001400325700001300339700002000352245005900372300001000431490000700441050003200448520118700480022001401667       1987                            d  c1987 Oct-Dec10aAmputation10aAnkle10aBiomechanical Phenomena10aBone Diseases10aHumans10aleprosy10aOrthopedic Equipment10aParalysis10aPeripheral Nervous System Diseases10aProstheses and Implants10aRadiography10aShoes10aStress, Mechanical1 aKulkarni V N1 aMehta J M1 aSane S B1 aSharangpani R C00aManagement of tarsal disintegration (T.D.) in leprosy.  a393-80 v59  aInfolep Library - available3 a<p>Tarsal Disintegration (T.D.) is a known entity occurring exclusively in neuropathic foot of Leprosy and being influenced by several factors among which the disease itself and altered biomechanics constitute the main. In this study done on more than fifty cases at the Dr. Bandorawalla Leprosy Hospital, Kondhawa these factors have been studied in detail and it has been found that the increased and abnormal shearing forces constitute one of the major factors both in occurrence and progression of T.D. Treatment based mainly on the conservative lines is thus aimed at minimizing these forces which occur during the heel-toe pattern gait. Depending upon the severity of the case immobilization, periodic check x-rays, graded weight bearing and suitable modified footwear appliance is recommended. A Fixed Ankle Brace (FAB) serves well controlling the ankle movements by its rocker action and ultimately reducing the forces occurring during the normal heel-toe pattern. It has also been found that if the case is detected early and treated promptly the process can be controlled satisfactorily. Careful screening in high risk group is stressed and health education emphasized.</p>  a0254-9395