| Accession Number | <strong>00001433-200408000-00004</strong>. |
|---|---|
| Author | Naidu, Sanjiv H |
| Institution | Department of Orthopaedic Surgery, Penn State College of Medicine, Hershey, Pennsylvania, USA |
| Title | |
| Source | Current Opinion in Orthopaedics. 15(4):220-225, August 2004. |
| Abstract | Purpose of review: No matter what the controversy, the National Academy of Sciences in a consensus statement in 2001 concluded that work-related upper extremity disorders are associated with high repetition, force, and vibration at the workplace. A surgeon or clinician who treats workers' compensation patients must be able to cope with the above conclusions despite his or her own biases. The following review is intended to provide the clinician with a practical approach to the most prevalent work-related entities. Recent findings: Objective physical findings, clear diagnostic criteria, and nonoperative solutions exist for specific entrapment neuropathies and tenosynovitis-tendonitis of the upper extremities. Constant health care use by injured workers without further medical benefit increases the health care costs. Summary: No specific objective findings can be documented in certain patients with idiopathic upper limb pain or nonspecific arm pain even after cessation of the noxious stimuli at work. Objective clinical criteria exist for many difficult situations where failure of surgical intervention is judged merely by subjective complaints of unrelenting pain. Clinicians and surgeons must exercise caution in giving specific diagnoses for patients in the latter category because it will invariably lead to unnecessary diagnostic procedures and potentially harmful surgical intervention. (C) 2004 Lippincott Williams & Wilkins, Inc. |