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Arthropathy of the wrist in leprosy--what changes are caused by long-standing peripheral nerve palsy?

Abstract

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.

More information

Type
Journal Article
Author
Nagano J
Tada K
Masatomi T
Horibe S
Year of Publication
1989
Journal
Archives of orthopaedic and trauma surgery
Volume
108
Issue
4
Number of Pages
210-7
Date Published
1989
Language
eng
ISSN Number
0936-8051
DOI
10.1007/bf00936203
Alternate Journal
Arch Orthop Trauma Surg
Publication Language
eng

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