@article{93832,
  author = {Mankar S and Kawalkar A and Sakhare R and Faizan M and Golhar A},
  title = {Results of  modified Bunnel’s technique in management of claw hand deformity caused by leprosy},
  abstract = {Leprosy primarily affects peripheral nerves and skin. Isolated ulnar nerve is most commonly involved, causing
partial clawing with the involvement of ring and little fingers. Additional involvement of median nerve
causes total clawing with involving all four fingers, with loss of action of intrinsic muscles of hand. Various
procedures like capsulodesis, tenodesis, arthrodesis, or tendon transfers like Littlers, Fowlers, and Brands are
recommended for correction of claw hand deformity. In this study we evaluated the results of modified
Bunnell’s procedure in patients with leprosy with ulnar or ulnar-median claw hand deformity. 42 claw hands in
30 patients with ulnar or ulnar-median claw hand deformity secondary to leprosy were operated with
modified Bunnell’s technique between January 2013 and July 2018. Functional assessment of the hand was
done using modified Brand’s criteria which includes three basic manoeuvres i.e. opening the hand fully,
making a closed fist and flexing the phalanxes sequentially and graded as poor, fair, good, and excellent.
Among these 30 patients included in the study there were 21 males and 9 females. Average age of
involvement was 31 years (range 18-54 years). Complete claw hand was seen in 14 and partial claw hand was
seen in 28 cases. All patients had improvement in grip strength. As per Brand scoring system the results were
excellent 18 (43%) cases, good in 21 (50%) and 3 (7%) hands had fair results. None of the patients had poor
results. All the patients were satisfied with the results. Modified Bunnel’s technique is safe, effective and
technically non-demanding procedure for surgical correction of claw hand deformity of leprosy irrespective of
joint condition. The only prerequisites for the Bunnell’s procedure include availability of Flexor digitorum
superficialis (FDS) along with working Flexor digitorum profundus (FDP).},
  year = {2020},
  journal = {Indian journal of leprosy},
  volume = {92},
  pages = {31-37},
  url = {http://www.ijl.org.in/2020/04%20S%20Mankar%20et%20al%2031-37%20(1).pdf},
  language = {eng},
}