Orthotic treatment for refractory plantar ulcers using distribution assessments of sensory disturbance and dynamic plantar pressure in patients with Hansen's disease: A case series

2019 ◽  
Vol 46 (7) ◽  
Author(s):  
Syoichi Tashiro ◽  
Yuki Oku ◽  
Naoki Gotou ◽  
Takahiro Sugano ◽  
Keita Kikuhara ◽  
...  
Sensors ◽  
2020 ◽  
Vol 20 (23) ◽  
pp. 6976
Author(s):  
Syoichi Tashiro ◽  
Naoki Gotou ◽  
Yuki Oku ◽  
Takahiro Sugano ◽  
Takuya Nakamura ◽  
...  

Orthoses and insoles are among the primary treatments and prevention methods of refractory plantar ulcers in patients with Hansen’s disease. While dynamic plantar pressure and tactile sensory disturbance are the critical pathological factors, few studies have investigated whether a relationship exists between these two factors. In this study, dynamic pressure measured using F-scan system and tactile sensory threshold evaluated with monofilament testing were determined for 12 areas of 20 feet in patients with chronic Hansen’s disease. The correlation between these two factors was calculated for each foot, for each clinical category of the foot (0–IV) and across all feet. A significant correlation was found between dynamic pressure and tactile sensation in Category II feet (n = 8, p = 0.016, r2 = 0.246, Spearman’s rank test). In contrast, no significant correlation was detected for the entire foot or within the subgroups for the remainder of the clinical categories. However, the clinical manifestation of lesion areas showed high variability: (1) pressure concentrated, sensation lost; (2) margin of pressure concentration, sensation lost; (3) pressure concentrated, sensation severely disturbed but not lost; and (4) tip of the toe. These results may indicate that, even though there was a weak relationship between dynamic pressure and tactile sensation, it is important to assess both, in addition to the basics of orthotic treatment in patients with Hansen’s disease presenting with refractory plantar ulceration.


Biomédica ◽  
2018 ◽  
Vol 38 (2) ◽  
pp. 153-161
Author(s):  
Héctor Serrano-Coll ◽  
Olinto Mieles ◽  
Calixto Escorcia ◽  
Amparo Díaz ◽  
Camilo Beltrán ◽  
...  

La lepra neural pura se presenta como una neuropatía periférica sin presencia de lesiones cutáneas.La verificación del diagnóstico mediante el índice bacilar y la histopatología, no es posible en la mayoría de los pacientes.Se describen cuatro casos de lepra neural pura diagnosticados por clínica; la evolución de tres de los pacientes que recibieron tratamiento específico fue satisfactoria, en tanto que la otra paciente presentó deterioro progresivo a pesar de las medidas terapéuticas. Todos los pacientes fueron atendidos en un centro especializado en el manejo y control de la enfermedad de Hansen, ubicado en el municipio de Contratación, Santander, Colombia.


2003 ◽  
Vol 2 (3) ◽  
pp. 164-167 ◽  
Author(s):  
V. S. Chauhan ◽  
S. S. Pandey ◽  
V. K. Shukla

Author(s):  
Isaac Olusayo Amole ◽  
Stephen Adesope Adesina ◽  
Adewumi Ojeniyi Durodola ◽  
Samuel Uwale Eyesan

Aim: To show how the surgery helped to eliminate the fear of the stigma associated with Hansen’s disease. Presentation of Cases: We present a case series of two patients with right ulnar nerve paralysis and one patient with left foot drop. They all underwent surgery for correction of their deformities with excellent outcome. Discussion: From the cases presented it was clear that though all of them were treated with multi-drug therapy for one year but they were still living under the fear of stigmatization until they had their deformities corrected through surgery. There was a great transformation in the lives of these affected individuals when they had their deformities corrected through surgery. They all overcame their fear of stigmatization after the successful surgery. Conclusion: Correction of deformities is one of the ways of eliminating fear of stigmatization among the patients who have residual deformities after completing their treatment for Hansen’s disease. The government and non-governmental agencies could do more to make the service readily available and accessible to these individuals. This will help in reintegrating the treated individual back into the community and it will eventually lead to the closure of Leprosy camps.


Author(s):  
Isaac Olusayo Amole ◽  
Stephen Adesope Adesina ◽  
Adewumi Ojeniyi Durodola ◽  
Samuel Uwale Eyesan

Aim: To highlight the functional outcome of surgical management of foot drop in patients with Hansen disease. Case Presentation:  We present three cases of foot drop following Hansen’s disease that were managed surgically by Tibialis posterior transfer. The patients had preoperative physiotherapy for ten days and postoperative physiotherapy for four weeks. Their post-operative periods were uneventful and the corrections were satisfactory. Discussion: Involvement of common peroneal nerve in Hansen’s disease usually results in paralysis of the anterior tibial and/or peroneal muscles. Hansen’s disease patients with foot-drop walk with a ‘high-stepping gait’, lifting the leg high as if climbing steps even while walking on level ground. When the paralysis has been present for more than six months to one year without recovery, the best option of treatment at this stage is corrective surgery and the main aim of the corrective surgery is to restore active dorsiflexion of the foot so that the gait becomes normal. This is achieved by re-routing the tendon of Tibialis posterior muscle, brings that tendon to lie in front of the ankle and is anchored distally. If the tendo-achillis tendon is found to be tight, it should be lengthened as the first step of the Tibialis posterior transfer operation. Conclusion: Surgical correction of foot drop usually leads to restoration of active dorsiflexion of the foot thereby preventing development of secondary deformities and ulceration. Our patients were able to dorsiflex their feet after the surgical correction.


2020 ◽  
Vol 3 (2) ◽  
pp. 116
Author(s):  
Hendra Gunawan ◽  
Deasy Natalia Adriana ◽  
Awalia Awalia ◽  
Joewono Soeroso

Hansen’s disease or leprosy is a chronic granulomatous infectious disease caused by Mycobacterium leprae. Musculoskeletal complaints might be the initial presentation of patients with Hansen’s disease. Symptoms are common with clinical spectrum ranging from mild to debilitating arthritis.  Regarding its wide clinical spectrum, a history taking especially in an endemic area like Indonesia on the possibility of Hansen’s disease cannot be ruled out in patients with arthritis. We reported 3 cases of arthritis in Hansen’s disease. First case was a 62-year-old Javanese female who had a deformity and chronic poly symmetry arthritis. Second case was a 45-year-old Javanese male with chronic bilateral knee pain as initial presentation of Hansen’s disease and the last case was 61-year-old Javanese male who had acute bilateral knee pain with erythematous maculae associated with Erythema Nodosum Leprosum. All cases responded to corticosteroid 1 mg/BW/day.


2021 ◽  
Vol 59 (4) ◽  
pp. 379
Author(s):  
Palak Chirania ◽  
Dipankar Das ◽  
Balmukund Agarwal ◽  
GaneshChandra Kuri

Sign in / Sign up

Export Citation Format

Share Document