224 chapter 26
Things to do every day
• Checkups: At the end of each day (or more often if you work
hard or walk far) examine your hands and feet carefully—or
have someone else examine them. Look for cuts, bruises, or
thorns. Also look for spots or areas on the hands and feet that
are red, hot, swollen, or show the start of blisters. If you find
any of these, rest the hands or feet until the skin is completely
normal again.
• If the skin gets dry and cracks, soak the feet daily in water for
at least 20 minutes. Then rub cooking oil, Vaseline, or lanolin
hand cream into them (not butter or animal fat. These attract
insects and rats).
• As you rub oil into the hands and feet, do stretching exercises
to keep the complete range of motion in the joints.
With continued daily care, most deformities of leprosy can be prevented.
PREVENTION of contractures and deformities in persons
with paralysis
Prevention of contractures from paralysis due to leprosy is similar to prevention
of hand and foot contractures due to polio and other forms of paralysis. (See p. 81.)
However, loss of feeling makes prevention more difficult.
Exercises to maintain full range of motion are covered in Chapter 42 (see especially
p. 370 to 373).
• Exercises to prevent fixed clawing of the hands can be done by . . .
. . . gently straightening the
fingers like this:
and like this:
Open your fingers
as much as you can
without help. Then
use your other hand to
open them the rest of
the way. Close fingers
and repeat.
• A good exercise to prevent ‘tiptoe’ contractures with ‘foot
drop’ is to stretch the heel cords by leaning forward against a
wall or by squatting with heels on the ground.
Footwear for persons without feeling in their feet
The best footwear has:
• a well-fitted upper part that does not rub and has
plenty of toe room (or leaves toes open).
• a soft innersole about 1 cm. thick.
• a tough under-sole so thorns, nails,
and sharp rocks do not injure foot.
• Footwear should be acceptable (not look too
strange or unusual) so that the person will use it.
AVOID:
• plastic shoes or sandals
• soft-soled sandals or thongs
that thorns can pass through
• using nails to fasten
heels and soles
(These might poke
through and injure
the foot. Better to
sew on soles or use
glue.)
NO!
Disabled village Children