No abstract available.
Cumulative Trauma Disorders*

OBJECTIVE: To study the reaction of tissues in the carpal tunnel after repeated flexion of wrist in order to verify the pathophysiology and pathomechanism of the carpal tunnel syndrome as a cumulative trauma disorder. METHOD: Six groups of adult rabbits (5 rabbits were allocated to each groups) were exposed to repeated contractions of the wrist flexors by the median nerve stimulation at the elbow level for different durations; 2 days, 1 week, 2 weeks, 3 weeks, 4 weeks, and 5 weeks. Histological evaluation, morphometric analysis, and electrophysiological studies were carried out after the stimulation. RESULTS: There were no typical nor consistent findings in the tissues in the carpal tunnel except the median nerve. Inflammatory cell infiltration and edematous changes were noted in the epineurial tissue of median nerve. Decrease of large myelinated fibers and changes of fiber shape were observed in the median nerve. On the morphometric analysis, fiber diameter was smaller in groups of longer exposure duration. Changes were most prominent in 5 weeks group and in the periphery of the nerve fascicle in all the groups. Significant reduction of amplitude and increase of duration of compound muscle action potential were noted on electrophysiological study of the median nerve. CONCLUSION: The authors concluded that repeated experimental wrist flexion could give rise to an injury of the median nerve in the carpal tunnel. Accumulation of microtrauma of median nerve by epineurial edema and direct mechanical compression seems to be the pathomechanism of the carpal tunnel syndrome as a cumulative trauma disorder.
Action Potentials ; Adult ; Carpal Tunnel Syndrome* ; Cumulative Trauma Disorders* ; Edema ; Elbow ; Humans ; Median Nerve ; Myelin Sheath ; Rabbits ; Wrist

CTDs have been a growing problems for US and European industries with higher incidence rate every year. In our country, we have just Started to recognize and to work on the problems in industry. In this respect, this would be the first ergonomic-based CTD study with medical data. Two automobile part plants were ergonomically and clinically surveyed for this study. Specifically,' 25 jobs from A industry and 51 jobs from B industry were matched with the clinical data. Two types of analysis were conducted. First, ergonomic job evaluation using CTD checklist was done for both industries to figure out the relative risks for each jobs. Second, comprehensive analysis for risk factors regarding CTDs was conducted. It produced mainly two results. First, multiple regression analysis of both worker and work-related factors on total scores based on the results of the'physical examination showed that there was no statistically significant relationships between total scores based on physical examinations and either worker or work-related risk factors. Second, logistic analyses for both factors were done. An user-friendly logistic program was developed for this analysis and for the future analysis of CTD study in the long-run. The program would have even non-expert in statistical package easily manipulate logistic analysis. Based on the logistic analysis, there was no significant relationships between worker related risk factors and all CTD types except marital status. However, there was some significant results in terms of work-related factors. Lateral pinch and ulnar deviations had significant relationship with both all CTD types and CTS. Power grip was associated with all types of CTDs, Tendinitis and Carpal Tunnel Syndrome. The cycle time had significant effects only on Carpal Tunnel Syndrome. In conclusion, the first ergonomic-based CTD study has been initiated in Korea. However, it was realized that good overall situation for CTD study in Korea has been before the right time yet. Therefore, futher research on the basis of the framework of this study is strongly suggested to have a complete CTD guidelines in the near future.
Automobiles ; Carpal Tunnel Syndrome ; Checklist ; Cumulative Trauma Disorders ; Hand Strength ; Human Engineering ; Incidence ; Korea ; Marital Status ; Physical Examination ; Risk Factors ; Tendinopathy

CTDs have been a growing problems for US and European industries with higher incidence rate every year. In our country, we have just Started to recognize and to work on the problems in industry. In this respect, this would be the first ergonomic-based CTD study with medical data. Two automobile part plants were ergonomically and clinically surveyed for this study. Specifically,' 25 jobs from A industry and 51 jobs from B industry were matched with the clinical data. Two types of analysis were conducted. First, ergonomic job evaluation using CTD checklist was done for both industries to figure out the relative risks for each jobs. Second, comprehensive analysis for risk factors regarding CTDs was conducted. It produced mainly two results. First, multiple regression analysis of both worker and work-related factors on total scores based on the results of the'physical examination showed that there was no statistically significant relationships between total scores based on physical examinations and either worker or work-related risk factors. Second, logistic analyses for both factors were done. An user-friendly logistic program was developed for this analysis and for the future analysis of CTD study in the long-run. The program would have even non-expert in statistical package easily manipulate logistic analysis. Based on the logistic analysis, there was no significant relationships between worker related risk factors and all CTD types except marital status. However, there was some significant results in terms of work-related factors. Lateral pinch and ulnar deviations had significant relationship with both all CTD types and CTS. Power grip was associated with all types of CTDs, Tendinitis and Carpal Tunnel Syndrome. The cycle time had significant effects only on Carpal Tunnel Syndrome. In conclusion, the first ergonomic-based CTD study has been initiated in Korea. However, it was realized that good overall situation for CTD study in Korea has been before the right time yet. Therefore, futher research on the basis of the framework of this study is strongly suggested to have a complete CTD guidelines in the near future.
Automobiles ; Carpal Tunnel Syndrome ; Checklist ; Cumulative Trauma Disorders ; Hand Strength ; Human Engineering ; Incidence ; Korea ; Marital Status ; Physical Examination ; Risk Factors ; Tendinopathy

Carpal tunnel syndrome, the entrapment neuropathy of median nerve within the carpal tunnel of the wrist, is a kind of cumulative trauma disorders, and major problem in occupational health, particularly in occupations requ iring highly repetitive hand motions. We examined 337 telephone operators, 674 hands to detect the incidence and the risk factors of carpal tunnel syndrome, and the efficient screening electrodiagnostic method. The symptomatic hands without slowing were 53 hands(7.9%) and the asymptomatic slowing hands were 30(4.5). 44 hands(6.5%) had symptoms or signs of carpal tunnel syndrome with slowing on nerve conduction, so diagnosed as carpal tunnel syndrome. The age, obesity and wrist dimension were risk factors of carpal tunnel syndrome. The hands with symptoms or slowing had lower grip strength and higher vibration threshold in the middle finger tip compared to normal group. The most sensitive method of nerve conduction was latency of median nerve at palm to wrist. This method was reliable and efficient nerve conduction study so can be recommended as screening procedure for identification of carpal tunnel syndrome in industrial settings.
Carpal Tunnel Syndrome* ; Cumulative Trauma Disorders ; Electrodiagnosis ; Fingers ; Hand ; Hand Strength ; Incidence ; Mass Screening* ; Median Nerve ; Neural Conduction* ; Obesity ; Occupational Health ; Occupations ; Prevalence* ; Risk Factors ; Telephone ; Vibration ; Wrist

OBJECTIVES: To report cubital tunnel syndrome due to repetitive motions. METHODS: A worker complaining muscle weakness and atrophy of the right hand intrinsic muscles admitted to a hospital. We evaluated him with blood tests, neurophysiologic studies (NCV & EMG), plain X-ray and US at the both elbows. We investigated his occupational history, and videotaped his work motions based on the work cycle at his previous work site. Finally, an ergonomics expert analyzed the motions using rapid upper limb assessment (RULA). RESULTS: NCV & EMG studies reveals slow conduction velocity on both ulnar nerve across the elbow, more severely in the right side. US shows us compatible finding with diffuse neuritis of both ulnar nerves at both elbows. RULA score is 7. CONCLUSION: We confirmed that the workers symptoms were related to his previous jobs demanding repetitive motions using the elbow joints. It is necessary that we should prepare appropriate measures to evaluate, prevent, rehabilitate, and help injured workers to return to work.
Atrophy ; Cubital Tunnel Syndrome* ; Cumulative Trauma Disorders ; Elbow ; Elbow Joint ; Hand ; Hematologic Tests ; Human Engineering ; Muscle Weakness ; Muscles ; Neuritis ; Return to Work ; Ulnar Nerve ; Upper Extremity ; Workplace

Iliotibial band (ITB) friction syndrome is a common overuse injury typically seen in the active athlete population. A nodular lesion on the inner side of the ITB as an etiology or an accompanying lesion from friction syndrome has been rarely reported. A 45-year-old male presented with recurrent pain and a movable nodule at the lateral joint area, diagnosed as ITB friction syndrome. The nodule was confirmed as a rare intra-articular fibroma of the tendon sheath (FTS) on the basis of histopathologic findings. We describe the MRI findings, arthroscopic and pathologic features, in this case of intra-articular FTS presenting with ITB friction syndrome.
Cumulative Trauma Disorders/complications/*diagnosis ; Fibroma/*etiology ; Friction ; Humans ; Iliotibial Band Syndrome/complications/*diagnosis ; Knee Joint/*pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pain/etiology ; Tendons/*pathology

Capsuloligamentous injury at the first metatarsophalangeal (MTP) joint is a common traumatic injury during physical activity, particularly on artificial turf. Mechanism of injury include excessive flexion, extension, or valgus stress. We report a non-operatively treated capsuloligamentous injury at the first MTP joint, which did not occur traumatically but developed by a stress-related mechanism in a collegiate rower.
Cumulative Trauma Disorders ; Joints ; Metatarsophalangeal Joint* ; Motor Activity

The purpose of this study is to investigate the current status of and to collect the basic informations of musculoskeletal diseases of upper extremities in manufacturing and telecommunication companies. The subjects were 213 workers, consisted Of 98 manufacturing workers and 115 telephoBfi operators. The musculoskeletal ,symptom survey, Job safety analysis (JSA), and medical examinations including neurologic, and'nerve.cqnduction velocity (NCV) test were conducted.: All workers were women in company A, while the other composed of 68(69.4%) men and 30(30.6%) women. The results were as follows: 1. The rates of self-reporting symptoms in each company were 85.2% at the neck, 81.1% at the shoulder joint, 73.0% at the wrist joint and 34.8% at the elbow joint in company A, while 56.1% at the shoulder joint, 51.2% at the neck and 23.5% at the elbow joint in company B in order. 2. No relationship was observed between the work duration and symptom rate in company A, but the highest symptom rate was observed at the neck in 10-19 year work duration group, at the shoulder, elbow and wrist joint in 5-9 year work duration group in company B. 3. Over the 22.8% of total workers in this study having symptoms got medical treatment at the medical clinics or drug stores, but there was no statistical difference between both companies. 4. In company A, 16(13.9%) workers were classified as D category, 12(10.4%) workers as C category and 2(1.7%) workers as R category among 115 workers. And D category was 10(10.2%), C category 31(31.6%) and R category 4(4.0%) among 98 workers in company B. D category means disease category needed futher treatment, C category means disease category needed no treatment and R category means recheck category, needed futher evaluation. 5. The types of musculoskeletal disorders including D, C, and R category were 46 cases(D 13, C 30, R 3) of tension neck .syndrome (TNS), 16 cases (D 3, C 8, R 5) of carpal tunnel syndrome (CTS), 5 cases of De Quervain's disease, 3 cases of lateral epicondylitis, 3 cases of bicipital tendinitis, 3 cases of rotator cuff tendinitis, 2 cases of medical epicondylitis, and 5 cases of cervical disc syndrome. 6. In company A, the total cases of 11 TNS, 8 CTS, 3 De Quervain's disease, 3 lateral epicondylitis, 3 rotator cuff tendinitis and 1 cervical disc syndrome were diagnosed and so were total cases of 35 TNS, 8 CTS and 4 cervical disc syndrome in company B. 7. By stepwise multiple regression analysis with dichotomization of musculoskeletal disease, the following odds ratios were significantly high (p<0.05)-sex (2.707) and age(l.926).
Carpal Tunnel Syndrome ; Cumulative Trauma Disorders ; De Quervain Disease ; Elbow ; Elbow Joint ; Female ; Humans ; Male ; Musculoskeletal Diseases* ; Neck ; Odds Ratio ; Rotator Cuff ; Shoulder ; Shoulder Joint ; Telecommunications* ; Tendinopathy ; Upper Extremity* ; Wrist Joint

The purpose of this study is to investigate the current status of and to collect the basic informations of musculoskeletal diseases of upper extremities in manufacturing and telecommunication companies. The subjects were 213 workers, consisted Of 98 manufacturing workers and 115 telephoBfi operators. The musculoskeletal ,symptom survey, Job safety analysis (JSA), and medical examinations including neurologic, and'nerve.cqnduction velocity (NCV) test were conducted.: All workers were women in company A, while the other composed of 68(69.4%) men and 30(30.6%) women. The results were as follows: 1. The rates of self-reporting symptoms in each company were 85.2% at the neck, 81.1% at the shoulder joint, 73.0% at the wrist joint and 34.8% at the elbow joint in company A, while 56.1% at the shoulder joint, 51.2% at the neck and 23.5% at the elbow joint in company B in order. 2. No relationship was observed between the work duration and symptom rate in company A, but the highest symptom rate was observed at the neck in 10-19 year work duration group, at the shoulder, elbow and wrist joint in 5-9 year work duration group in company B. 3. Over the 22.8% of total workers in this study having symptoms got medical treatment at the medical clinics or drug stores, but there was no statistical difference between both companies. 4. In company A, 16(13.9%) workers were classified as D category, 12(10.4%) workers as C category and 2(1.7%) workers as R category among 115 workers. And D category was 10(10.2%), C category 31(31.6%) and R category 4(4.0%) among 98 workers in company B. D category means disease category needed futher treatment, C category means disease category needed no treatment and R category means recheck category, needed futher evaluation. 5. The types of musculoskeletal disorders including D, C, and R category were 46 cases(D 13, C 30, R 3) of tension neck .syndrome (TNS), 16 cases (D 3, C 8, R 5) of carpal tunnel syndrome (CTS), 5 cases of De Quervain's disease, 3 cases of lateral epicondylitis, 3 cases of bicipital tendinitis, 3 cases of rotator cuff tendinitis, 2 cases of medical epicondylitis, and 5 cases of cervical disc syndrome. 6. In company A, the total cases of 11 TNS, 8 CTS, 3 De Quervain's disease, 3 lateral epicondylitis, 3 rotator cuff tendinitis and 1 cervical disc syndrome were diagnosed and so were total cases of 35 TNS, 8 CTS and 4 cervical disc syndrome in company B. 7. By stepwise multiple regression analysis with dichotomization of musculoskeletal disease, the following odds ratios were significantly high (p<0.05)-sex (2.707) and age(l.926).
Carpal Tunnel Syndrome ; Cumulative Trauma Disorders ; De Quervain Disease ; Elbow ; Elbow Joint ; Female ; Humans ; Male ; Musculoskeletal Diseases* ; Neck ; Odds Ratio ; Rotator Cuff ; Shoulder ; Shoulder Joint ; Telecommunications* ; Tendinopathy ; Upper Extremity* ; Wrist Joint