Orthopedics
Orthopedics
Study says repetitive use not to blame for common injuries
There's no basis to industrial claims that work-related repetitive use causes seven common foot and ankle problems, according to a study presented at the annual meeting of the American Orthopaedic Foot and Ankle Society (AOFAS) held recently in Orlando, FL.
"We found it difficult to distinguish long-term foot and ankle problems as a result of daily activity from those that were job-related," notes the study's first author, Gregory P. Guyton, MD, assistant professor of orthopaedic surgery at the University of North Carolina in Chapel Hill. "Walking is walking, whether it's done at work or outside work," he says.
Clinical and legal perspectives
The concept of cumulative occupational trauma in the foot and ankle has generated interest in both the medical and legal communities. An increasing number of industrial claims have been filed for foot and ankle repetitive motion problems, similar to claims for arm, wrist, and hand injuries as a result of computer use in the workplace, according to AOFAS.
"For example, an employee could say they developed a bunion because they're on their feet all day at work," says Guyton. "But the bunion could be caused by the type of shoes they wear in their leisure activities."
Researchers reviewed literature on work-related foot and ankle problems published in English-language medical journals in the past
25 years. The study looked at these common disorders: arthritis of the foot and ankle, toe deformities, pinched nerves between the toes, heel pain, adult-acquired flat foot, and tarsal tunnel syndrome, which is increased pressure on the major nerve of the foot as it passes the ankle.
Researchers applied three criteria to the available data for each disorder:
• increased prevalence of disorder within a particular industrial population;
• evidence that isolated the disorder as job-related rather than from daily activities;
• whether a particular industrial environment would cause disorders in a normal person if he or she were exposed to it.
Researchers say the study will have an impact on both the medical and legal arenas, says co-author Roger A. Mann, MD, of Oakland, CA. "Employers will not have to spend money to settle industrial claims which have no merit," he says.
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