Surgical correction of claw fingers in Hansen's disease by palmar plate shortening and pulley advancement.

A simple technique has been used to correct the clawing of fingers in patients with Hansen's disease. The distal part of the palmar plate is excised and the remaining portion is advanced and sutured with a single horizontal mattress suture to prevent hyperextension of the metacarpophalangeal joint. A pulley advancement is also done. One hundred five claw hands were corrected in 99 patients from December 1985 to September 1988. Follow-up period varied from 6 months to 3 1/2 years. The results were assessed for correction of deformity, power grip, motion, and function. Out of 94 hands that were followed up after operation, power grip remained static in most cases. Correction of deformity was satisfactory in 85 hands, motion and function of the fingers were satisfactory in 63 hands, and correction of the clawing was statistically significant in two fingers (p less than 0.01).