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Tarsal disintegration (T.D.) in leprosy.

V N Kulkarni, J M Mehta

    Leprosy in India
    |April 1, 1983
    PubMed
    Summary

    Tarsal disintegration in leprosy is complex, but biomechanical factors like muscle imbalance significantly worsen foot damage. Understanding these factors is key to preventing severe complications in leprosy patients.

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    Area of Science:

    • Orthopedics
    • Rheumatology
    • Podiatry

    Background:

    • Tarsal disintegration (TD) in leprosy presents significant challenges in prevention.
    • The etiology of TD is multifactorial, involving insensitivity, loss of protective reflexes, infection, and bone infiltration.

    Observation:

    • This study examined 16 neuropathic feet (15 burnt-out tuberculoid/borderline tuberculoid, 1 active lepromatous leprosy).
    • Clinical and radiological assessments, including radiograph tracings, were performed.
    • Emphasis was placed on biomechanical factors, specifically altered muscle pulls and resultant weight-bearing changes.

    Findings:

    • Biomechanical factors, alongside insensitivity, significantly contribute to the progression of tarsal disintegration.
    • TD is predominantly observed in the Tuberculoid leprosy variety.
    • Kinetic and kinematic analysis revealed distinct differences between normal and neuropathic feet.

    Implications:

    • Understanding biomechanical influences is crucial for developing effective prevention strategies for tarsal disintegration in leprosy.
    • This research highlights the importance of a biomechanical approach in managing neuropathic foot complications.
    • Further research into kinetic and kinematic analysis can refine treatment and prevention protocols for leprosy-related foot deformities.

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