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

Abstract

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. This case report of compression neuropathy in the upper limbs is unusual because of the bilateral involvement of the median and ulnar nerves. The patient was a parquet floorer, an occupation that is not included among those at risk of CTS and distal neuropathy of the ulnar nerve.Case report A 43 year old man was referred to the Department of Occupational Medicine, University of Perugia, Italy, because numbness and paraesthesias had been present in all fingers of both hands for about one year. No other symptoms were present. A floorer for about 25 years, the patient was mainly occupied in hand laying parquet flooring. At work he used different glues and had the habit of pressing each wooden block into position with the base of the palm and the volar surface of both wrists. For about 80 hours every month, he also used a heavy electric floor sander and polisher that produced vibrations.

Work Disabling Nerve Injury at Both Elbows Due to Laptop Use at Flexible Workplaces inside an Office: Case-Report of a Bilateral Ulnar Neuropathy

“…Furthermore, Web of Science and UpTodate was used. We included thirteen original studies that addressed the topic of work and ulnar neuropathy [ 12 , 13 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ]. In addition, a review was included [ 27 ].…”

Multiple Nerve Damages Because of Occupational Risk Factors

“…On the other hand, Rogier reported that while stationary working was a risk factor for cubital tunnel, working with the wrist at full extension or static working and work that necessitates loading with more than 1 kg for more than 10 times in an hour were risk factors for radial nerve entrapment. In a case of a floor parqueting worker who was required to perform repetitive hand movements, bilateral carpal tunnel syndrome at the Guyon's canal was reported, in addition to ulnar nerve entrapment [18].…”