Outcome of modified Bunnell′s procedure in the management of leprotic claw hand deformity

Clawing, partial or total due to leprosy affects greatly, hand's ability for fine movements, grip and skilful use along with loss of tactile sensation of hand, which usually precedes the motor weakness. We reviewed and evaluated the functional results of Modified Bunnel's procedure in management of 20 patient of leprosy with 28 claw hand deformity. After mean followup of 18 months (range 12-38 months) results were excellent in 10 (35%) cases, good in 12 (42.8%), fair in 4 (14.2%) and poor in 2 (7.1%). 97% of the patients (27/28) had improvement in the grip except one case (3%). Swan-neck deformity, flexion contracture, check-rein deformity and insufficient finger flexion was seen in none of the cases whereas superficial minus deformity of ring finger was seen in only 1 case. Modified Bunnel's procedure is simple to perform and gives superior results as it gives least possible adhesions, provides straight course for the tendon and good leverage with normal angle, with better cosmetic results and patient satisfaction.