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THE EXTENSOR DIVERSION GRAFT OPERATION FOR CORRECTION OF INTRINSIC MINUS FINGERS IN LEPROSY

H. Srinivasan 1

1 Central Leprosy Teaching and Research Institute, Chingleput; India

1. A new procedure, called "the extensor diversion graft operation", has been devised for correcting the deformity and reducing the disability of the intrinsic minus fingers so commonly seen in leprosy.

2. The procedure consists of the insertion of a free tendon graft which spans the metacarpophalangeal joint along its volar aspect and is attached at both ends to the extensor mechanism, to the extensor tendon proximally and to the lateral band distally.

3. The procedure reduces extensor dominance at the metacarpo-phalangeal joint and improves the balance of forces, allowing the assumption of a straight posture by use of the extrinsic muscles.

4. The assessment of function of ninety-seven fingers on average eight months after operation has shown that in addition to correction of deformity, this procedure in the majority of cases also restores partial independence of movement at the metacarpo-phalangeal and proximal interphalangeal joints, to such an extent that the finger can reach and hold a functionally useful position.

5. One advantage of the procedure is that it obviates the need for re-education of muscles.
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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General