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Anatomy, physiology and disease
Published in C M Langton, C F Njeh, The Physical Measurement of Bone, 2016
Other disorders of bone are associated with abnormalities in the BMU. For example, Paget’s disease is an uncommon, sometimes heritable, focal disorder characterized by accelerated bone resorption. The remodelling unit is disordered, with a massive increase in bone resorption accompanied by a significant increase in bone formation. Although the key pathophysiological component of this disease relates to osteoclastic recruitment, bone formation is accelerated so dramatically that the result is the production of primary or woven bone rather than lamellar bone. These changes can be detected on plane radiographs and are frequently found in the spine, pelvis and skull (figure 1.6). Since woven bone is abnormal in respect to orientation and strength, it is also more fragile. This results in an increased likelihood of spontaneous fracture at sites of Paget’s involvement. In addition, localized pain, nerve entrapment and malignant degeneration can also occur. Treatment with agents such as the bisphosphonates, which slow bone turnover, are considered the first line of therapy for this disorder.
Prevalence and risk factors for self-reported symptoms of carpal tunnel syndrome among hospital office workers: a cross-sectional study
Published in International Journal of Occupational Safety and Ergonomics, 2023
Carpal tunnel syndrome (CTS) occurs as a result of compression of the median nerve in the carpal tunnel at the wrist joint level and is the most common peripheral nerve entrapment disease. CTS is not a simple condition but a serious cause of disability, and is defined as the upper extremity musculoskeletal disease associated with the highest cost among working-age patients in relation to taking sick leave, decreased productivity and personal financial losses [1]. The US Bureau of Labor Statistics reported that all musculoskeletal problems were responsible for an estimated 32.2 cases and an average 12 days off work per 10,000 workers in 2015, in all industries in the USA, while CTS accounted for the highest number of workdays lost (on average, 28 days off work per case) [2]. Early detection of CTS can also be a critical factor affecting the return to work. Workers with a correct and early diagnosis of CTS were found to be much more likely to return to work than workers diagnosed weeks or months later [3].
Cross-sectional changes of the distal carpal tunnel with simulated carpal bone rotation
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Carpal tunnel syndrome is a peripheral nerve entrapment syndrome affecting a large portion of the general (Atroshi et al. 1999) and working populations (Dale et al. 2013; Luckhaupt et al. 2013). The most common treatment for carpal tunnel syndrome is to undergo carpal tunnel release surgery, whereby pressure at the median nerve is relieved by transecting the transverse carpal ligament (TCL) (Badger et al. 2008; Rodner and Katarincic 2008). Regarding various patient outcome measurables, surgical treatment shows preferred results, as compared to those for therapeutic options such as splinting (Gerritsen et al. 2002), non-steroidal anti-inflammatory drugs (Jarvik et al. 2009) and steroid injections (Hui et al. 2005). Although surgery is more effective, the invasive nature of the procedure does present the risk of complications, albeit rare (Karl et al. 2016). Such risks are minimal with noninvasive physical therapeutics. These options, which can include splinting (Huisstede et al. 2010) and carpal bone mobilization (Huisstede et al. 2010), often involve force application at or near the radiocarpal or midcarpal joint. These force applications are likely to induce relative motion of the carpal bones.
Grip strength of occupational workers in relation to carpal tunnel syndrome and individual factors
Published in International Journal of Occupational Safety and Ergonomics, 2020
Greesh Kumar Singh, Sanjay Srivastava
Safe methods in occupational tasks minimize risks of workplace injuries [1–3]. Many research studies have presented such methods including intelligent ones for a variety of occupational health problems [4–9]. Carpal tunnel syndrome (CTS) is one of the most common known nerve entrapment syndromes among occupational workers. Determining the association of grip strength with CTS for occupational workers exposed to high risk of CTS is the main focus of the present study. Grip strength is the maximum grip force-producing capability of an individual. Some occupational jobs require grip exertion that exceeds the grip strength of a worker, which in turn may cause hand injury. Prehensile movements of the hand involve seizing and holding an object within the compass of the hand [10]. Muscular force application is dominant in the power grip of prehensile movements. The nature of occupational work often calls for power gripping activities that usually impose tremendous strain in the hands, either through the exertion of great forces or from highly repetitive or sustained contraction.