The clinical data of 71 patients with
leprosy plantar ulcers and treated with different surgical methods between October 1950 and October 2006 were analyzed retrospectively. In group A, 34 cases underwent
debridement, including 26 males and 8 females aged 53-88 years old (average 72.4 years old); the course of
ulcer averaged 29.0 years; the size of
ulcer ranged from 5 cm x 3 cm x 2 cm to 11 cm x 7 cm x 3 cm; the disability degrees of the affected foot was mild in 25 cases and severe in 9 cases according to the self-designed evaluation system. In group B, 22 cases received foot pressure rebuilding surgery, including 19 males and 3 females aged 48-83 years old (average 69.8 years old); the course of
ulcer averaged 33.5 years; the size of
ulcer ranged from 5 cm x 3 cm x 2 cm to 12 cm x 7 cm x 3 cm; the disability degrees of the affected foot was mild in 12 cases and severe in 10 cases. In group C, 15 cases were repaired with the transposition of toe flap, foot arch flap, acrotarsium flap, or medial tibia flap, including 11 males and 4 females aged 43-73 years old (average 64.6 years old); the course of
ulcer averaged 29.3 years; the size of
ulcer ranged from 6 cm x 3 cm x 2 cm to 11 cm x 5 cm x 3 cm; the disability degrees of the affected foot was mild in 9 cases and severe in 6 cases. No significant differences were evident among three groups in terms of the general information (P > 0.05), except for the difference between group A and group C on age (P < 0.05).
RESULTS: Group
A: 19 out of 34 cases healed and the average healing time was 46.8 days; all patients were followed up for 2-45 years (average 17.2 years); the rate of
ulcer healing 1 year after operation was 55.9% (19/34); 12 healed
ulcer patients relapsed at average 1.5 years after operation; the rate of
ulcer healing at last follow-up was 20.6% (7/34). Group B: 18 out of 22 cases healed and the average healing time was 29.2 days; all patients were followed up for 2-50 years (average 13.3 years); the rate of
ulcer healing 1 year after operation was 81.8% (18/22); 7 healed
ulcer patients relapsed at average 3.3 years after operation; the rate of
ulcer healing at last follow-up was 50.0% (11/22). Group C: 14 out of 15 cases healed and the average healing time was 27.1 days; all patients were followed up for 3-12 years (average 8.8 years). The rate of
ulcer healing 1 year after operation was 93.3% (14/15); 7 healed
ulcer patients relapsed at average 4 years after operation; the rate of
ulcer healing at final follow-up was 46.7% (7/15). For the rate of
ulcer healing 1 year after operation, there was a significant difference between group A and group B, and between group A and group C (P < 0.05), but no significant difference was evident between group B and group C (P > 0.05). For the rate of
ulcer healing at the final follow-up visit, there was a significant difference between group A and group B (P < 0.05), but no significant difference was evident between group A and group C, and between group B and group C (P > 0.05).
CONCLUSION: