CASE REPORT
Bilateral hypermobility of ulnar nerves at the elbow joint with unilateral left ulnar neuropathy in a computer user: A case study
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1
Nofer Institute of Occupational Medicine, Łódź, Poland
(Department of Occupational Diseases and Toxicology, Out-patient Clinic of Occupational Diseases)
2
Medical University of Lodz, Łódź, Poland
(Clinic of Orthopaedics and Pediatric Orthopaedics)
3
Nofer Institute of Occupational Medicine, Łódź, Poland
(Department of Occupational Diseases and Toxicology)
Corresponding author
Magdalena Lewańska
Nofer Institute of Occupational Medicine, Department of Occupational Diseases and Toxicology, Out-patient Clinic of Occupational Diseases, św. Teresy 8, 91-348 Łódź, Poland
Int J Occup Med Environ Health. 2016;29(3):517-22
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ABSTRACT
Occupational ulnar neuropathy at the elbow joint develops in the course of long term direct pressure on the nerve and
a persistently flexed elbow posture, but first of all, it is strongly associated with “holding a tool in a certain position” repetitively.
Therefore, computer work only in exceptional cases can be considered as a risk factor for the neuropathy. Ulnar
hypermobility at the elbow might be one of the risk factors in the development of occupational ulnar neuropathy; however,
this issue still remains disputable. As this condition is mostly of congenital origin, an additional factor, such as a direct acute
or chronic professional or non-professional trauma, is needed for clinical manifestations. We describe a patient – a computer
user with a right ulnar nerve complete dislocation and left ulnar nerve hypermobility, unaware of her anomaly until
symptoms of left ulnar neuropathy occurred in the course of job exposure. The patient was exposed to repetitive long lasting
pressure of the left elbow and forearm on the hard support on the cupboard and desk because of a non-ergonomically
designed workplace. The additional coexistent congenital abnormal displacement of the ulnar nerve from the postcondylar
groove during flexion at the elbow increased the possibility of its mechanical injury. We recognized left ulnar neuropathy at
the ulnar groove as an occupational disease. An early and accurate diagnosis of any form of hypermobility of ulnar nerve,
informing patients about it, prevention of an ulnar nerve injury as well as compliance with ergonomic rules are essential to
avoid development of occupational and non-occupational neuropathy.