"Mouse"-trap or personal computer palsy

Wrist Posture during Computer Mouse Usage

In this experiment, we investigated the effects that mouse pad surface height and wrist support had on wrist posture. In a pointing task, 16 subjects moved a mouse-controlled cursor clockwise or counterclockwise around three fixed targets, which varied by size and distance depending on task condition. Wrist extension, flexion, radial deviation, and ulnar deviation data were collected via a wrist monitor attached to the right hand and forearm.

The presence of a wrist support decreased wrist extension and radial deviation, and increased wrist flexion. Higher pad surface height resulted in increased flexion and ulnar deviation, and decreased extension and radial deviation. A comparison of the conditions which were at the same pad height, but differed due to the presence or absence of wrist support, revealed that wrist extension was reduced by the presence of a wrist support at all but the highest height.

Guyon tunnel syndrome secondary to excessive healing tissue in a child: a case report

We describe a case of an 8-year-old boy who developed a combined motor and sensory neuropathy of the distal ulnar nerve, after sustaining a superficial injury to the right flexor carpi ulnaris tendon at the level of the distal wrist crease. Guyon's canal syndrome is a very rare entity during childhood. We have noted only one prior description of this syndrome in the pediatric age group in a review of the English literature.

Anatomy of nerve entrapment sites in the upper quarter

The purpose of this article is to review the anatomical features of the most common nerve entrapment sites of the brachial plexus and major peripheral nerves of the upper limb. In this account, the term "entrapment" is considered to be caused by compression, tension, or friction, or any combination of these factors. The anatomy, including important relationships of the brachial plexus, is reviewed and the points of potential entrapment of the plexus are described. Entrapment of the suprascapular and long thoracic nerves is also included. Particular attention is paid to the five major peripheral nerves that result from the brachial plexus and supply the peripheral aspect of the upper limb, i.e., the median, ulnar, musculocutaneous, radial, and axillary nerves. In each case, the nerve's course is described and the anatomical details of the entrapment points described. Where possible, the sites of entrapment are illustrated in cadaveric photographs.

Computer mouse use and cumulative trauma disorders of the upper extremities

The computer mouse is now present in virtually every office environment because of the recent adoption of the graphical user interface. However, Karlqvist et al. (1994) pointed out that there still remains a paucity of work on the musculoskeletal problems associated specifically with computer mouse use. Likewise, there have been no published data on the magnitude of upper extremity musculoskeletal disorders associated with computer mouse use. In order to ascertain this magnitude, claims data from the Liberty Mutual Group were reviewed for the years 1986 to 1993, inclusive. Count, total cost and average cost per claim for all claims associated with computer use and computer mouse use were determined for the years in question. It was concluded that although there are few claims related to computer mouse use, it appears to be a growing problem, and therefore, perhaps, deserves more research and intervention attention. However, the present magnitude is less than for other musculoskeletal disorders.

Bilateral median and ulnar neuropathy at the wrist in a parquet floorer

Many cases of work related compression neuropathy of the ulnar and median nerves at the wrist have been described. This report presents a case of bilateral distal neuropathy of the median and ulnar nerves in a parquet floorer, who laid wooden block flooring by hand and used the palms and volar surface of both hands to hit the blocks into place. He also used an electric sander and polisher. Bilateral numbness and paraesthesias in all fingers had been present for about one year. Clinical examination was normal; the neurological assessment indicated slight impairment in response to tactile, heat, and pain stimuli in all 10 fingers. Electroneurography showed increased distal motor latencies of median and ulnar nerves at both wrists, although the lower limbs were normal. The results of blood, urine, and instrumental tests excluded systemic disease or local factors that could cause compression neuropathy. After stopping work for three months, the clinical picture and electroneurographic results improved. These data support the hypothesis that the damage to the median and ulnar nerves had been caused by the patient's way of working, which provoked repeated bilateral microtrauma to his wrists. To diagnose work related multiple neuropathy can be difficult and an accurate work history is necessary. Preventive measures and diligent health care are required for this category of worker.