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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 1999 October;50(5):177-84
Carpal tunnel syndrome of possible occupational origin
Oprandi G., Buzzi F., Baracco A., Berra A., Brach del Prever E. M.
Background. Interest in carpal tunnel syndrome (CTS) is linked to the increased incidence of this pathology, the absence of diagnostic protocols and standardized ergonomic principles of risk analysis, and the need to evolve preventive measures. This study aimed to analyse the existing problems and start to elaborate criteria for the correct management of CTS of possible occupational origin.
Methods. A clinical evaluation was made of 21 workers in metal and mechanical companies who had been diagnosed and operated for CTS and who had filed claims for indemnity from INAIL. The ergonomic analysis of occupational risk was made before and after surgery.
Results. The higher incidence in women does not depend on an unequal selection of occupational risk factors. Poor posture represents a major risk factor. Individual risk factors, when associated, are correlated with less satisfactory surgical results. Neurophysiological tests do not provide all the necessary parameters for a full evaluation. The strength of the operated hand is significantly reduced. There is no association between the surgical technique used and levels of strength. Occupational risk factors were eliminated after surgery and the subjects were successfully reinserted into the working environment.
Conclusions. Further studies are required to clarify the relationship between occupational, non-occupational and individual risk factors. Priority should be given to the need to standardize diagnostic protocols and the method of analysing occupational risk. It is also important to evaluate the efficacy of early immobilization in order to prevent the onset of chronic pathology.