Flexor aponeurotic release for resistant adaptive shortening of long flexors in claw hands in leprosy

Adaptive shortening of long flexors (ASLF) is a consequence of long-standing neglected claw finger deformity. While adaptive shortening of muscle fibres is correctable by physiotherapy, concurrent shortening of fascia/aponeurosis/intermuscular septum, composed of inelastic collagen fibres is not. Surgical excision of these structures has been advised in ASLF in cerebral palsy. This procedure in which a 3-4 cm wide band of deep fascia of the forearm, about 6 cm distal to the medial epicondyle, along with the intermuscular septum is excised was tried in seven patients having severe or moderately severe ASLF with good results. This procedure is worth a more extensive trial.