[Surgery of leprosy at the Institut Marchoux in Bamako during the last 20 years].
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Biomedical subjects
Publications and source records attributed to P Giraudeau.
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The authors have observed 15 cases of the tarsal canal syndrome: the 14 cases operated on showed compression of the nerve by bone fragments resulting from trauma by local varices, by a muscular anomaly, or as a result of enclosure by post-trauma fibrosis. Surgery resulted in 10 cures and considerable improvement in 2 other cases. In addition to these 15 "pure" cases the authors report their experience of neurolysis of the posterior tibial nerve and of the plantar nerves of the tarsal canal in the treatment of perforating plantar lesions in leprosy (88 cases) and diabetes (12 cases). The good results in these cases indicate the value of extending this therapy to the treatment of perforating plantar lesions in cases of large nerve neuritis.
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The neurologic examination of 90 leprosy subjects shows the importance of nerve enlargement and associated sensorimotor deficiencies. The association of various clinical signs, the ones in contrast to the others and the influence of the history of the illness are taken in consideration. Finally these results are compared with some previous works.
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In order to get a representative sample of the population, a survey was conducted in an rural district of the Republic of Mali. The data collected give evidence that the number of specific surgical indications can be correctly evaluated not from the number of leprosy patients numbered, but by applying a ratio of 5,5 per cent to the whole population. This easy evaluation is important for the management of any public health programme.
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