GD07 From disability to ability: a clinicoepidemiological study of reconstructive surgeries in a leprosy-endemic district

Abstract Despite its official elimination as a public health problem, leprosy continues to impact individuals in endemic regions of the world, leaving many with physical deformities. These deformities, often a consequence of delayed diagnosis and nerve damage, can lead to significant stigma, disability and socioeconomic hardship. This study aimed to assess the burden of leprosy-related deformities and evaluate the outcomes of reconstructive surgery in an endemic district, providing valuable insights into the ongoing challenges and potential solutions. A cross-sectional study was conducted among patients with leprosy presenting to a primary health centre of an endemic district, between August 2022 and August 2024. Data on demographics, leprosy history, deformity type, surgical interventions and functional outcomes were collected using a structured questionnaire and clinical examination. In total, 26 patients with leprosy-related deformities were included. The average age was 37 years (range 12–57); 18 were male and eight female. The most common deformities observed were 58% claw hand, 35% foot drop and 8% facial paralysis. Medial Fascia substitution using four-tailed plication surgery was the most common surgery, performed in 50% of patients. The correlation of age and deformity had a P-value of 0.64, and for sex and deformity it was P = 0.12. Postoperatively, significant improvements were observed in functional improvements, for example hand function, mobility and facial symmetry, with all patients experiencing positive outcomes. This study highlights the transformative impact of reconstructive surgeries in improving the quality of life of individuals with leprosy-related disabilities. Beyond physical restoration, these interventions address social stigma and foster reintegration into society. Our findings emphasize the importance of integrating surgical care into leprosy control programmes, particularly in endemic regions, to bridge the gap between disability and ability. This also highlights the need for active screening of cases in district blocks that have a high incidence of deformities in children. Strengthening leprosy control programmes, early case detection and improving access to reconstructive services are crucial for achieving true elimination of leprosy and its debilitating consequences. Moving forward, replicating such models can inspire broader initiatives, ensuring dignity, functionality and empowerment for those affected by leprosy worldwide.