Factores de riesgo y síndrome del túnel carpiano en el entorno laboral

Resumen

Introducción Las neuropatías compresivas son las patologías neurológicas periféricas más frecuentes del miembro superior, suponiendo una de las principales causas de pérdida de días laborales. El síndrome del túnel del carpo (STC), es la más frecuente, y se produce por un atrapamiento del nervio mediano a su paso por el túnel carpiano resultando en un daño de tipo isquémico y mecánico. El objetivo de este estudio, fue investigar la relación causal entre la exposición a distintos factores de riesgo laborales y el STC en nuestro medio.

Material y Método Estudio descriptivo, observacional de casos-control restrospectivo. Doscientos veinte pacientes fueron diagnosticados con STC en el área de influencia de nuestro centro hospitalario. Se efectuó tratamiento quirúrgico en pacientes con manifestaciones clínico-electroneurofisiológicas de intensidad moderada-severa y falta de respuesta a medidas conservadoras.

Resultados  Noventa y un pacientes fueron hombres (41,4%) y 129 mujeres (58,6%), todos en edad laboral, con una edad media de 45,26 años. El 85% presentaban alta repetición de movimientos de la muñeca. La mayoría presentaba afectada la extremidad dominante. Fueron intervenidos mediante descompresión quirúrgica 191 pacientes y 29 se trataron con medidas conservadoras. Se estudió la prevalencia del STC según los distintos gremios de trabajadores y factores de riesgo.

Conclusión Existe un mayor riesgo en profesiones con elevada repetición de movimientos de muñeca, de padecer STC con respecto a las profesiones que tienen baja repetición. La afectación de la mano no dominante tiene un riesgo menor que la mano dominante o la bilateral. El sexo femenino, obesidad, diabetes, artritis reumatoide e hiperuricemia, presentan mayor riesgo de STC, aunque no estadísticamente significativo. Como conclusión, existen determinadas profesiones que pueden aumentar el riesgo de padecer este síndrome, así como patologías endocrinas. Sin embargo, no se puede asumir que exista una relación causal suficiente para desencadenarlo.

Abstract

Introduction Compressive neuropathies are the most frequent peripheral neurological pathologies of the upper limb assuming one of the leading causes of loss of workdays. Carpal tunnel syndrome (CTS) is the most common, caused by an entrapment of the median nerve as it passes through the carpal tunnel, resulting in ischemic and mechanical damage. The objective was to investigate the causal relationship between exposure to occupational risk factors and carpal tunnel syndrome.

Material and Method retrospective, descriptive, observational case-control study. 220 patients were diagnosed with carpal tunnel syndrome in the area of influence of our hospital center. Surgical treatment was performed in patients with clinical-electroneurophysiologicals manifestations of moderate-severe intensity and lack of response to conservative measures.

Results 91 patients were men (41.4%) and 129 women (58.6%), all working age, with an average age of 45.26 years. 85% had high repetition of wrist movements. dominant extremity was most presented affected. Were operated by surgical decompression 191 patients and 29 were treated with conservative measures. Carpal tunnel syndrome prevalence was studied according to the different workers ' unions and risk factors.

Conclusion There is a greater risk in professions with high repetition of wrist movements to suffer carpal tunnel syndrome respect to the professions that had low repetition. Non-dominant hand involvement has a lower risk than the dominant or bilateral hand. The female sex, obesity, diabetes, rheumatoid arthritis and hyperuricemia, present greater risk of carpal tunnel syndrome but not statistically significant. In conclusion, there are certain professions that can increase the risk of developing this syndrome, as well as endocrine pathologies. However, it cannot be assumed that there is sufficient causal relationship to trigger it.

Palabras Clave

neuropatías compresivas - lesiones de muñeca - síndrome del túnel del carpo

Keywords

entrapment neuropathies - wrist injuries - carpal tunnel syndrome

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