02499nas a2200241   4500000000100000008004100001653001400042653002600056653001200082653002400094100001200118700001500130700001300145700001700158700001800175700001300193700001300206245009100219856005100310300001000361490000700371520187900378       2018                            d10aClaw hand10aFunctional evaluation10aleprosy10aNerve decompression1 aNeto BC1 aFontana AP1 aSilva DC1 aDe Freitas E1 aDa Cunha AJLA1 aE Sa VWB1 aGomes MK00aFunctional evaluation of the hand after ulnar claw correction in patients with leprosy  uhttps://leprosyreview.org/article/89/1/02-5035  a25-350 v893 a<p>Purpose: To evaluate hand function in leprosy patients after reconstructive surgery for claw hand.<br />
Methods: Patients who had completed multidrug therapy (MDT) and who had undergone tendon transfer surgery for ulnar claw correction at either of two reference centres for leprosy in Brazil between 2010 and 2014, were included. Clinical evaluations, Screening of Activity Limitation and Safety Awareness (SALSA) Scale, Disabilities of the Arm, Shoulder, and Hand Score (DASH) Questionnaire and the Jebsen Taylor Test (JTT) were used to measure arm/hand function recovery after surgery. Data were analyzed with the one sample t-test ( p , 0·05).<br />
Results: Twenty-three patients participated in the study, with 13 males (57%), a mean age of 49·5 years and an average of 6·3 years post-surgery. On the SALSA Scale total score, 59% of the individuals had mild or no limitation of activity. On the specific score for the hand domain, 91% had mild or no limitation. The mean score of the DASH Questionnaire was 24·45. On the JTT, when comparing individuals who had surgery on the right hand with normative values for the dominant hand, matched for mean age and gender, there was a significant difference for all six tasks. When comparing individuals who had surgery on the left hand with normative values for the non-dominant hand, there was greater proximity between the means, although still significantly different.<br />
Conclusions: The SALSA, DASH and JTT were easily applicable and useful to measure the functional limitation of the leprosy hand. The data demonstrated that the patients had a good impression of their hand’s improved functionality after surgery. Patients exhibited mild to no disability. These results reinforce the importance of early diagnosis of neuritis and immediate therapeutic interventions to prevent physical disability.</p>