Occupational risk factors for radial tunnel syndrome in industrial workers.

OBJECTIVES: The aim of the study was to evaluate both nonoccupational and occupational factors associated with radial tunnel syndrome (RTS) among industrial workers in 3 large plants. METHODS: Twenty-one cases of RTS were compared with 21 referents matched for gender, age, and plant. RTS was associated with carpal tunnel syndrome (CTS) in 9 cases. Past medical history, household activities, and ergonomic and organizational characteristics of the job were analyzed. RESULTS: The study found 3 occupational risk factors for RTS. Exertion of force of over 1 kg [odds ratio (OR) 9.1, 95% confidence interval (95% CI) 1.4-56.9] more than 10 times per hour was the main biomechanical risk factor. Prolonged static load applied to the hand during work was strongly associated with RTS (OR 5.9, 95% CI 1.2-29.9). Work posture with the elbow fully extended (0-45 degrees) was associated with RTS (OR 4.9, 95% CI 1.0-25.0). Full extension of the elbow, associated with a twisted posture of the forearm, stressed the radial nerve at the elbow. However, personal activities, household chores, and sport and leisure activities were not associated with RTS. CONCLUSIONS: The study confirms that RTS occurs in workers performing hard manual labor that requires forceful and repetitive movements involving elbow extension and forearm prosupination.

[Radial tunnel syndrome. Study of a continuous and homogenous series of 35 cases]. / Syndrome du tunnel radial. Etude d'une série homogène et continue de 35 cas.

Thirty-five patients in a continuous and homogenous series of radial tunnel syndromes treated surgically between 1980 and 1987 were re-examined by an independent observer with a follow-up greater than six months. Electromyographic studies in each case had confirmed the presence of a neurological lesion and such studies were considered to be of value when nerve compression was combined with other local painful conditions. Neurolysis was performed with optical magnification through a lateral approach. The clinical results were assessed using the criteria of Roles and Maudsley. Apart from one case which showed an inadequate result, there were 14 excellent, 11 good and 9 fair results. Post-operative electromyographic studies were performed in 30 cases and showed a significant improvement in the shape and adequacy of the tracings compared with the pre-operative condition. Among the fair or poor results, 60 per cent showed an associated radiculopathy of C7 compared with 16 per cent in the good and excellent results.

[Occupational risk factors for radial tunnel syndrome in factory workers]. / Facteurs de risque professionnels du syndrome du tunnel radial chez les salariés de l'industrie de production de masse.

STUDY: The purpose of the study was to evaluate the professional and extraprofessional risk factors for radial tunnel syndrome (RTS) in employees of three large companies. METHOD: Twenty-one cases of RTS were compared to 21 controls, matched for age, sex, and activity. In nine cases, RTS was associated with carpal tunnel syndrome. The analysis considered medical history, extraprofessional activity, and the ergonomic and organisational aspects of work. RESULTS: The study demonstrated three risk factors of RTS related to work conditions. The regular use of a force of at least 1 kg (OR = 9.1 (1.4-56.9)) more than 10 times per hour is the main biomechanical risk factor. Static work (OR = 5.9 (1.2-29.9)) as well as work with the elbow constantly extended 0 degree to 45 degrees, is strongly associated with an increased risk of RTS (OR = 4.9 (1.0-25.0)). Complete extension of the elbow associated with pronation and supination of the forearm may cause trauma to the radial nerve in the radial tunnel. On the other hand, we found no personal factors and no extraprofessional activities which were associated with an increased risk of RTS. CONCLUSIONS: This study shows that motions of the forearm requiring intense effort and performed with the elbow in extension and the forearm in pronation and supination increase the risk of RTS.

Central sympathetic dysregulation and immunological abnormalities in a case of progressive facial hemiatrophy (Parry-Romberg disease).

A case of hemifacial atrophy (Parry-Romberg disease) is discussed. Electrophysiological and immunological studies were performed. Electromyography, blink reflex and trigeminal evoked potential abnormalities indicate that the brain stem may be implicated in the aetiology of the disease. Immunological evidence favoured this possibility and demonstrated possible involvement of the noradrenergic system. Hyperactivity of the brain stem sympathetic centres, possibly caused by an autoimmune process, may be the primary cause of the cutaneous and subcutaneous atrophy in Parry-Romberg disease.