1
|
Węgiel A, Karauda P, Zielinska N, Tubbs RS, Olewnik Ł. Radial nerve compression: anatomical perspective and clinical consequences. Neurosurg Rev 2023; 46:53. [PMID: 36781706 PMCID: PMC9925568 DOI: 10.1007/s10143-023-01944-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/01/2023] [Accepted: 01/16/2023] [Indexed: 02/15/2023]
Abstract
The radial nerve is the biggest branch of the posterior cord of the brachial plexus and one of its five terminal branches. Entrapment of the radial nerve at the elbow is the third most common compressive neuropathy of the upper limb after carpal tunnel and cubital tunnel syndromes. Because the incidence is relatively low and many agents can compress it along its whole course, entrapment of the radial nerve or its branches can pose a considerable clinical challenge. Several of these agents are related to normal or variant anatomy. The most common of the compressive neuropathies related to the radial nerve is the posterior interosseus nerve syndrome. Appropriate treatment requires familiarity with the anatomical traits influencing the presenting symptoms and the related prognoses. The aim of this study is to describe the compressive neuropathies of the radial nerve, emphasizing the anatomical perspective and highlighting the traps awaiting physicians evaluating these entrapments.
Collapse
Affiliation(s)
- Andrzej Węgiel
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, Poland
| | - Piotr Karauda
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, Poland
| | - Nicol Zielinska
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, Poland
| | - R Shane Tubbs
- Department of Anatomical Sciences, St. George's University, Grenada, USA
- Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Neurology, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Neurosurgery, Ochsner Medical Center, New Orleans, LA, USA
| | - Łukasz Olewnik
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, Poland.
| |
Collapse
|
2
|
Mikkelsen S, Petersen R, Lund CB, Petersen JA, Thomsen JF. Reliability and validity of expert assessments of hand-wrist physical exposures. Am J Ind Med 2022; 65:132-142. [PMID: 34865239 DOI: 10.1002/ajim.23318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 11/15/2021] [Accepted: 11/23/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND General population job-exposure matrices (JEMs) based on expert assessments of physical exposures may be valuable tools for studying occupation-related musculoskeletal disorders. Wrist-hand JEMs are few and the reliability and validity of expert assessments of wrist-hand exposures is uncertain. METHODS We examined intra- and inter-rater reliability of ratings of five experts of hand-wrist repetition, deviation, force, vibration, and computer work in 33 jobs selected to represent a large exposure variation. The validity of ratings of hand-wrist repetition was examined by comparison with electro-goniometer measurements of wrist angular velocity and mean power frequency (MPF), and the validity of hand-wrist deviation by comparison with goniometer measurements of range of motion (ROM). RESULTS Intra-rater test-retest and inter-rater Spearman correlation coefficients controlling for rater effects, varied between 0.70 and 0.87. Corresponding kappa statistics of overall agreement showed similar high values, except for wrist deviation (kappa = 0.50). Regression analyses showed strong positive associations between expert assessments of repetition and goniometer measurements of wrist angular velocity (R2 = 0.56, p < 0.0001) and MPF (R2 = 0.37, p < 0.0003), while expert ratings of wrist deviation showed a weak statistically nonsignificant association with goniometer measurements of ROM (R2 = 0.032, p = 0.34). CONCLUSION The reliability of expert assessments of wrist-hand physical exposures was high. Compared to goniometer measurements, the validity of assessments of wrist-hand repetition was also high, but it was low for assessments of wrist-hand deviation. The results are encouraging for establishing a hand-wrist JEM, but the results for wrist deviation emphasize that expert assessments should be validated against objective measurements.
Collapse
Affiliation(s)
- Sigurd Mikkelsen
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital Copenhagen University Hospital Copenhagen Denmark
| | - Rolf Petersen
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital Copenhagen University Hospital Copenhagen Denmark
- Department of Occupational and Social Medicine, Holbæk Hospital Part of Copenhagen University Hospital Holbæk Denmark
| | - Christina Bach Lund
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital Copenhagen University Hospital Copenhagen Denmark
| | - Jonathan Aavang Petersen
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital Copenhagen University Hospital Copenhagen Denmark
| | - Jane Frølund Thomsen
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital Copenhagen University Hospital Copenhagen Denmark
| |
Collapse
|
3
|
Johanning E, Stillo M, Landsbergis P. Powered-hand tools and vibration-related disorders in US-railway maintenance-of-way workers. INDUSTRIAL HEALTH 2020; 58:539-553. [PMID: 32863315 PMCID: PMC7708743 DOI: 10.2486/indhealth.2020-0133] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Maintenance-of-way workers in North America who construct railroad tracks utilize specialized powered-hand tools, which lead to hand-transmitted vibration exposure. In this study, the maintenance-of-way workers were surveyed about neuro-musculoskeletal disorders, powered-hand tools and work practices. Information about vibration emission data of trade specific powered-hand tools for the North American and European Union markets was searched online to obtain respective user information of manufacturer and compared to non-commercial international data banks. The survey showed that maintenance-of-way workers frequently reported typical hand-transmitted vibration-related symptoms, and appear to be at a risk for neuro-musculoskeletal disorders of the upper extremity. Of all of the powered-hand tools used by this trade, 88% of the selected tools exceeded a=5 m/s2 and were above vibration magnitudes of common tools of other comparable industries. This may create a risk if these tools are used throughout an 8-h work day and management of vibration exposure may be needed. In the North-American market, limited or no vibration emission data is available from manufacturers or distributors. Vibration emission information for powered-hand tools, including vibration emission levels (in m/s2), uncertainty factor K, and the applied testing standard/norm may assist employers, users and occupational health providers to better assess, compare and manage risk.
Collapse
Affiliation(s)
| | - Marco Stillo
- Downstate School of Public Health, State University of New York (SUNY), USA
| | - Paul Landsbergis
- Downstate School of Public Health, State University of New York (SUNY), USA
| |
Collapse
|
4
|
Nambiema A, Bertrais S, Bodin J, Fouquet N, Aublet-Cuvelier A, Evanoff B, Descatha A, Roquelaure Y. Proportion of upper extremity musculoskeletal disorders attributable to personal and occupational factors: results from the French Pays de la Loire study. BMC Public Health 2020; 20:456. [PMID: 32252693 PMCID: PMC7137334 DOI: 10.1186/s12889-020-08548-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 03/18/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Upper extremity musculoskeletal disorders (UEMSD) are one of the most common and costly occupational health problems. We aimed to assess the population-attributable fraction (PAF) of personal and occupational risk factors associated with incident UEMSD in a working population. METHODS From 2002 to 2005, a random sample of 3710 workers from the Pays de la Loire region in France, aged 20-59 were included by occupational physicians (OPs). Between 2007 and 2010, 1611 workers were re-examined by their OPs. Subjects free from UEMSD at baseline were included in this study (1275 workers, mean age: 38.2 years). Cox regression models with equal follow-up time and robust variance estimates were used to estimate age-adjusted and multivariable-adjusted relative risks (RRs) and their 95% confidence intervals (CIs). Based on multivariable models, PAF associated with each factor included in the models was estimated. RESULTS During the follow-up period, 143 (11%) cases of UEMSD were diagnosed. PAFs for factors associated with the incident UEMSD risk were 30% (7 to 51) for high physical exertion (RPE Borg scale ≥12), 12% (- 0.2 to 24) for low social support, 7% (- 3 to 17) for working with arms above shoulder level (≥2 h/day), 20% (12 to 28) for age group ≥45, 13% (3 to 22) for the age group 35-44, and 12% (0.3 to 24) for female gender. CONCLUSIONS Our study suggests that an important fraction of UEMSD can be attributed to occupational exposures after the contributions of personal and other work-related factors are considered. In terms of public health, our findings are in agreement with the ergonomic literature postulating that a high proportion of UEMSD are preventable through modifying workplace risk factors. Such information is useful to help public health practitioners and policy makers implement programs of prevention of UEMSD in the working population.
Collapse
Affiliation(s)
- Aboubakari Nambiema
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-49000 Angers, France
| | - Sandrine Bertrais
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-49000 Angers, France
| | - Julie Bodin
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-49000 Angers, France
| | - Natacha Fouquet
- Santé publique France, the French national public health agency, Direction of Occupational Health, EpiprevTMS team associated to the University of Angers, F-49000 Angers, France
| | - Agnès Aublet-Cuvelier
- INRS, Département Homme au travail, 1 rue du Morvan CS60027, 54519 Vandoeuvre, France
| | - Bradley Evanoff
- Division of General Medical Sciences, Washington University School of Medicine, St. Louis, St. Louis, MO 13 63310 USA
| | - Alexis Descatha
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-49000 Angers, France
- Inserm, UMS 011, unité cohortes épidémiologiques en population, Villejuif, France
| | - Yves Roquelaure
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-49000 Angers, France
| |
Collapse
|
5
|
Hulkkonen S, Lampainen K, Auvinen J, Miettunen J, Karppinen J, Ryhänen J. Incidence and operations of median, ulnar and radial entrapment neuropathies in Finland: a nationwide register study. J Hand Surg Eur Vol 2020; 45:226-230. [PMID: 31739732 DOI: 10.1177/1753193419886741] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The aim of this study was to investigate the incidence rates and operations for carpal tunnel syndrome and ulnar and radial neuropathies in specialist care in Finland. Patients diagnosed with entrapment neuropathies of the upper extremity were identified from the Care Register for Health Care, 2007-2016. There were 81,911 cases in 54,095,070 person-years. The total crude incidence rates per 100,000 person-years among women and men were 197 and 105 for carpal tunnel syndrome, 26 and 36 for ulnar neuropathies, and 5.7 and 8.5 for radial neuropathies, respectively. Of these, carpal tunnel syndrome was operated on in 63% of women and 61% of men, ulnar neuropathy in 43% of women and 47% of men, and radial neuropathy in 11% of women and 8% of men. Incidence of carpal tunnel syndrome and ulnar neuropathies increased up to late middle age, while radial neuropathies were less common. Level of evidence: III.
Collapse
Affiliation(s)
- Sina Hulkkonen
- Department of Hand Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Kaisa Lampainen
- Department of Hand Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Juha Auvinen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Jaro Karppinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Finnish Institute of Occupational Health, Oulu, Finland *Hulkkonen Sina and Lampainen Kaisa have contributed equally to this work
| | - Jorma Ryhänen
- Department of Hand Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| |
Collapse
|
6
|
Vimercati L, Cavone D, Caputi A, Delfino MC, De Maria L, Ferri GM, Serio G. Malignant mesothelioma in construction workers: the Apulia regional mesothelioma register, Southern Italy. BMC Res Notes 2019; 12:636. [PMID: 31564247 PMCID: PMC6767638 DOI: 10.1186/s13104-019-4675-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 09/21/2019] [Indexed: 12/11/2022] Open
Abstract
Objective Asbestos was widely used in construction in both a friable and a compact form until the 1990s, before its use was banned. Today, many of these materials are still in situ and represent a source of risk for construction workers. The objective of the study was to analyse the cases of mesothelioma arising among construction workers registered in the Apulia regional register of mesothelioma. Results For the period 1993–2018, there were 178 male cases, and 10.2% of the cases were present in the regional register. The average age at diagnosis was 64.7 years. The site was pleural in 96.06% of cases, with a diagnosis of certainty in 86.5% of the total cases and 61.8% of cases with epithelial histology. The average latency is 43.9 years. In 75.2% of cases, the exposure began between 1941 and 1970, with an average duration of 24.3 years. The age at the start of exposure in 68.5% of cases is between 8 and 20 years. The ORs were 2.5 (C.I. 95% 1.01–6.17) for the epithelioid histotype and the high duration of exposure. The data underline the need for prevention and information on all activities involving construction workers in which asbestos-containing materials are still used.
Collapse
Affiliation(s)
- L Vimercati
- School of Medicine, Interdisciplinary Department of Medicine (DIM), Ramazzini Occupational Medicine Section, "Policlinico" University Hospital, UOC of Occupational Medicine, University of Bari "A. Moro", Piazza G, Cesare 11, 70124, Bari, Italy.
| | - D Cavone
- School of Medicine, Interdisciplinary Department of Medicine (DIM), Ramazzini Occupational Medicine Section, "Policlinico" University Hospital, UOC of Occupational Medicine, University of Bari "A. Moro", Piazza G, Cesare 11, 70124, Bari, Italy
| | - A Caputi
- School of Medicine, Interdisciplinary Department of Medicine (DIM), Ramazzini Occupational Medicine Section, "Policlinico" University Hospital, UOC of Occupational Medicine, University of Bari "A. Moro", Piazza G, Cesare 11, 70124, Bari, Italy
| | - M C Delfino
- School of Medicine, Interdisciplinary Department of Medicine (DIM), Ramazzini Occupational Medicine Section, "Policlinico" University Hospital, UOC of Occupational Medicine, University of Bari "A. Moro", Piazza G, Cesare 11, 70124, Bari, Italy
| | - L De Maria
- School of Medicine, Interdisciplinary Department of Medicine (DIM), Ramazzini Occupational Medicine Section, "Policlinico" University Hospital, UOC of Occupational Medicine, University of Bari "A. Moro", Piazza G, Cesare 11, 70124, Bari, Italy
| | - G M Ferri
- School of Medicine, Interdisciplinary Department of Medicine (DIM), Ramazzini Occupational Medicine Section, "Policlinico" University Hospital, UOC of Occupational Medicine, University of Bari "A. Moro", Piazza G, Cesare 11, 70124, Bari, Italy
| | - G Serio
- School of Medicine, Department of Emergency and Organ Transplantation (DETO), Division of Pathology, University of Bari "A. Moro", Piazza G, Cesare 11, 70124, Bari, Italy
| |
Collapse
|