The patient chosen for case analysis presented with multisystem involvement of his hands bilaterally as a result of peripheral neuropathy secondary to Hansen's disease. Hansen's disease is a chronic disease caused by Mycobacterium leprae, an acid-fast bacillus. It is essentially a disease of the skin and peripheral nerves causing sensory and motor defects. The patient reviewed already had previous reconstructive surgery to the left hand in 1950 and 1964 at the U.S. Public Health Service Hospital, Carville, LA. He returned to Carville in 1987, seeking correction of problems that reoccurred in the left hand since 1964 and for surgery for the right hand. This case represents problems with peripheral nerves, soft tissue remodeling, joint disease secondary to aging, and surgical wound and skin care. Results to be described were excellent considering the age of the individual, length of time of deformities, and skin and joint tightness. These factors together presented a challenge for optimum correction.