Dermadesis and flexor pulley advancement: first report on a simple operation for correction of paralytic claw fingers in patients with leprosy.

A simple operation is described for correcting the intrinsic minus finger deformity commonly seen in patients with leprosy. It consists of shortening the palmar skin at the level of the MP joint and flexor pulley advancement. This produces an acceptable flexion contracture of not more than 40 degrees of the MP joint, as in Zancolli's capsuloplasty, and optimizes the balance of forces around the finger joints in favor of improved MP joint flexion and PIP joint extension. A preliminary evaluation of 11 hands of patients with leprosy with ulnar or ulnar and median nerve paralysis who underwent this surgery and were followed for 7 to 17 months after surgery shows that this operation satisfactorily corrects claw deformity and improves intrinsic minus disability. The most important advantages of this procedure are that it is technically simple and does not require postoperative reeducative therapy.