What is claw hand and can it be corrected?

Clawing of the hands or toes is a common disability caused by leprosy. Leprosy starts damaging the small nerves in the skin's surface, but if left untreated it begins affecting the large nerves in the elbow, wrist, knee and ankle. The resulting damage can lead to loss of sensation in the hands and feet and muscle paralysis, which causes clawed fingers and toes.

In the late 1940s, Dr Paul Brand became the first surgeon in the world to use reconstructive surgery to correct the deformities of leprosy in the hands and feet. Movement can be restored by using a muscle transfer technique where, with the help of a physiotherapist, a muscle is identified for transfer and strengthened. After surgery and several weeks in plaster, the patient is taught how to use their old muscle to do a new job and then apply the technique subconsciously. The results can see a leprosy-affected person walk again without dragging their foot on the ground or use their hand to grip items.

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