Upper extremities musculoskeletal disorders: prevalence and associated ergonomic factors in an electronic assembly factory.

OBJECTIVES: To determine the magnitude, distribution and associated ergonomic factors of upper extremities musculoskeletal disorders (UEMSD) among workers of electronic assembly in Thailand. MATERIAL AND METHODS: This was a cross-sectional study. 591 of 853 workers in an electronic and electrical appliance assembly factory in Bangkok, Thailand, participated in this study. A self-administered questionnaire consisting of demographic data and ergonomic factors was collected from October 2010 to January 2011. Clinical examination of each worker was performed by an occupational physician. The criteria for diagnosis of UEMSD came as a result of a consensus reached by a group of orthopedists. The associated factors were analyzed using a multiple logistic regression. RESULTS: The point prevalence of clinically diagnosed UEMSD was as follows: radial styloid tenosynovitis - 13.03% (95% CI: 10.31-15.75), trigger finger - 9.48% (95% CI: 7.11-11.84), carpal tunnel syndrome - 8.12% (95% CI: 5.91-10.33), lateral epicondylitis - 3.38% (95% CI: 1.92-4.85), and medial epicondylitis - 1.69% (95% CI: 0.65-2.73), respectively. The adjusted odds ratio with statistical significance associated with UEMSD was as follows: high force of wrist - 1.78 (95% CI: 1.06-2.99), awkward posture of wrist - 2.37 (95% CI: 1.28-4.37) and contact stress at wrists - 1.75 (95% CI: 1.02-3.00) to develop radial styloid tenosynovitis. For trigger finger, the ratios were awkward posture of fingers - 2.09 (95% CI: 1.12-3.90) and contact stress on finger - 1.86 (95% CI: 1.04-3.34). For medial epicondylitis, it was an awkward posture of using elbows - 3.14 (95% CI: 1.10-8.95). However, this study did not find any associations between repetitive motion and any UEMSD. CONCLUSIONS: UEMSD are most commonly found in electronic assembly workers. The relevant parties should provide comprehensive ergonomic resolution for these workers.

Early, continuous, passive motion following flexor tendon repair in zone-II: using an originally invented passive motion device.

OBJECTIVE: To evaluate the invented device for early continuous passive motion with the rehabilitation program of fingers following flexor tendon repair in zone-II and to determine whether early motion of the affected finger can occur without increasing the rates of subsequent tendon rupture. MATERIAL AND METHOD: A quazi experimental study was done between January 2011 and August 2011 by selecting 5 cases with both, flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) injuried in zone II of a finger using standard exclusion criteria. The operation was performed by a single surgeon using a standard four-strand repair suture technique and postoperative care consisted of a rehabilitation program with early continuous, passive motion using and original device. The program was started 1 week post operatively with duration of 4 months. The authors evaluated the total active motion (TAM) by means of the Strickland-Glogovac formula and calculated results by using the Strickland's original classification system. The ratio of efficiency (E1/E2) was analyzed. RESULTS: In evaluation of the TAM, there were 2 cases with excellent results and good results in 3 cases. The range of motion obtained was nearly full motion in all 5 of the cases without subsequent tendon rupture. The ratio of efficiency (E1/E2) was 85/ 100 (85 of Baktir/100 of the present study) and higher than standard (80/80). As the total number of cases and the selection of cases were different (76 cases of Baktir/5 cases of the present study). CONCLUSION: Early continuous passive motion using this originally invented device provides excellent long-term outcomes in the management of injured flexor tendon in zone II. Further studies should be done to compare our results with other continuous passive motion protocols with the inclusion of long term follow-up and measurements of grip strength.