Epidemiology of occupational injuries and illnesses in a university population: A focus on age and gender differences

Saleh, Shadi; Fuortes, Laurence J.; Vaughn, Thomas; Bauer, Eric P.

doi:10.1002/ajim.1057

Cited by 22 publications

(14 citation statements)

References 14 publications

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“…[24][25][26][27] The most commonly noted epidemiological association with CTS is high force, high repetition activity. [4][5][6][7][8][9][10][11][12] The connection, if any, between these two observations is unknown, although some studies 25,28 have shown that the SSCT of patients with CTS is less permeable than normal SSCT, and might therefore predispose to pressure elevation. Although the tensile strength and viscoelastic behavior of tendon has been well studied, [29][30][31][32][33][34][35] to date there have been no studies assessing the motion characteristics of the flexor tendons within the carpal tunnel, or even demonstrating a method to do so.…”

Section: Discussionmentioning

confidence: 99%

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Gliding characteristics between flexor tendons and surrounding tissues in the carpal tunnel: A biomechanical cadaver study

Zhao

Ettema

Osamura

et al. 2006

Journal Orthopaedic Research

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The purpose of this study was to investigate the gliding characteristics of flexor tendons within the carpal tunnel with varied wrist positions and tendon motion styles, which may help us to understand the relationship between carpal tunnel syndrome (CTS) and repetitive hand motion. Eight fresh human cadaveric wrists and hands were used. The peak (PGR) and mean (MGR) gliding resistance of the middle finger flexor digitorum superficialis tendon were measured with the wrist in 0, 30, and 608 of flexion and extension. While moving all three fingers together, the PGR at 608 flexion was significantly higher than that at 0, 30, or 608 extension. While moving the middle finger alone, the PGR at 60 and 308 flexion was significantly higher than the PGR at 608 extension. The PGR moving the middle finger FDS alone was significantly greater than that for all three digits moving together in 0, 30, and 608 flexion. Differential finger motion with wrist flexion elevated the tendon gliding resistance in the carpal tunnel, which may be relevant in considering the possible role of wrist position and activity in the etiology of CTS. ß

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Section: Discussionmentioning

confidence: 99%

“…2,3 It is generally accepted that repetitive, forceful hand or wrist motion, often associated with awkward wrist posture, is a risk factor for CTS, [4][5][6][7][8][9][10][11][12] but how these mechanical factors relate to the pathological changes of noninflammatory synovial thickening seen typically in cases of CTS is unknown.…”

Section: Introductionmentioning

confidence: 99%

Gliding characteristics between flexor tendons and surrounding tissues in the carpal tunnel: A biomechanical cadaver study

Zhao

Ettema

Osamura

et al. 2006

Journal Orthopaedic Research

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“…It is often described as an occupational disease among persons who perform repetitive work with their hands (Abbas et al, 1998;Armstrong et al, 1984;Saleh et al, 2001;Stal et al, 1999;Szabo, 1998;Wu et al, 2003). The most commonly reported pathological finding is non-inflammatory fibrosis and thickening of the subsynovial connective tissue (SSCT) (Armstrong et al, 1984;Ettema et al, 2004;Kerr et al, 1992;Lluch, 1992;Nakamichi et al, 1998;Neal et al, 1987;Phalen, 1966).…”

Section: Introductionmentioning

confidence: 99%

Flexor tendon and synovial gliding during simultaneous and single digit flexion in idiopathic carpal tunnel syndrome

Ettema

Zhao

et al. 2008

Journal of Biomechanics

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The characteristic pathological finding in carpal tunnel syndrome (CTS) is non-inflammatory fibrosis of the subsynovial connective tissue (SSCT), which lies between the flexor tendons and the visceral synovium (VS). How this fibrosis might affect tendon function is unknown. To better understand the normal function of the SSCT, the relative motion of the middle finger flexor digitorum superficialis (FDS III) tendon and VS was observed during finger flexion in patients with CTS and cadavers with a history of CTS and compared to normal cadavers.A digital camcorder was used to monitor the gliding motion of the FDS III tendon and SSCT in eight patients with idiopathic CTS undergoing carpal tunnel surgery (CTR), in eight cadavers with an antemortem history of CTS and compared these with eight cadaver controls.There were no significant differences noted in the total movement of the SSCT relative to the FDS III. However, the pattern of SSCT movement relative to the FDSIII in the CTS patients and cadavers with an antemortem history of CTS differed from the controls in one of two patterns, reflecting either increased SSCT adherence to FDS III or increased SSCT dissociation from FDS III. In CTS the gliding characteristics of the SSCT are qualitatively altered. These changes may be the result of increased fibrosis within the SSCT, which in some cases has ruptured, resulting in SSCT-tendon dissociation. Similar changes are also identified post mortem in the CTS patient.

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“…One hypothesis is that overuse from forceful, repetitive hand motions causes cumulative trauma to structures within the tunnel. Epidemiological studies showed that highly repetitive work is related to an increased risk for CTS . In vivo studies found biomechanical alterations of the tissues within the carpal tunnel in CTS patients …”

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confidence: 99%

The effect of low‐ and high‐velocity tendon excursion on the mechanical properties of human cadaver subsynovial connective tissue

Filius

Thoreson

Yang

et al. 2013

Journal Orthopaedic Research

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SUMMARY Fibrosis of the subsynovial connective tissue (SSCT) in the carpal tunnel is the most common histological finding in carpal tunnel syndrome (CTS). Fibrosis may result from damaged SSCT. Previous studies found that with low-velocity (2 mm/s), tendon excursions can irreversibly damage the SSCT. We investigated the effect of tendon excursion velocity in the generation of SSCT damage. Nine human cadaver wrists were used. Three repeated cycles of ramp-stretch testing were performed simulating 40, 60, 90 and 120% of the middle finger flexor tendon superficialis physiological excursion with an excursion velocity of 60 mm/s. Energy and force were calculated and normalized by values obtained in the first cycle for each excursion level. Data were compared with low-velocity excursion data. For high-velocity excursions, a significant drop in the excursion energy ratio was first observed at an excursion level of 60% physiological excursion (P<0.024) and that for low-velocity excursions was first observed at 90% physiological excursion (P<0.038). Furthermore, the energy ratio was lower at 60% for high velocities (P≤0.039). Increasing velocity lowers the SSCT damage threshold. This finding may be relevant for understanding the pathogenesis of SSCT fibrosis, such as that accompanying CTS, and a relationship with occupational factors.

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Epidemiology of occupational injuries and illnesses in a university population: A focus on age and gender differences

Abstract: These group differences suggest the need to examine age and gender job distributions and relevant ergonomic and environmental causative factors.

Cited by 22 publications

References 14 publications

Gliding characteristics between flexor tendons and surrounding tissues in the carpal tunnel: A biomechanical cadaver study

Gliding characteristics between flexor tendons and surrounding tissues in the carpal tunnel: A biomechanical cadaver study

Flexor tendon and synovial gliding during simultaneous and single digit flexion in idiopathic carpal tunnel syndrome

The effect of low‐ and high‐velocity tendon excursion on the mechanical properties of human cadaver subsynovial connective tissue

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