Entrapment neuropathies of the upper extremity, including carpal tunnel syndrome (CTS) and ulnar and radial neuropathies are common in the general population. The most common of these is CTS, the prevalence of which can be up to 5%. These neuropathies cause loss of hand function, disability, sick leaves and high health care costs. Up to two thirds of diagnosed cases are treated surgically. However, their aetiology is multifactorial and is still not fully understood. This study evaluated the incidence rate and the proportion of surgically treated cases of CTS, ulnar nerve entrapment (UNE) and radial neuropathies in the Finnish population, based on data from the Care Register for Health Care on hospitalizations in specialist care, 2007–2016. The risk factors for CTS and UNE were studied in the Northern Finland Birth Cohort 1966 (NFBC1966), whose participants attended a clinical examination in 1997 and gave their written informed consent (N = 8 719). For CTS, occupational exposures were studied in a sub-population of NFBC1966 participants who worked at least three days a week at study baseline in 1997at the age of 31. In the Finnish population, the crude incidence rates (95% confidence interval, CI) per 100 000 person-years between 2007 and 2017 among women and men were 196.5 (194.8–198.2) and 104.8 (103.6–106.0) for CTS, 25.8 (25.2–26.4) and 36.0 (35.2–36.7) for UNE, and 5.7 (5.4–6.0) and 8.5 (8.2–8.9) for radial entrapment neuropathies. Of these, CTS was operated in 62.6% of women and 61.3% of men, UNE in 43.2% of women and 47.2% of men, and radial nerve entrapment in 11.4% of women and 7.7% of men. CTS was more common among women (women : men risk ratio, RR = 1.4), whereas UNE and radial neuropathies were more common among men (men : women RR = 1.4 and 1.5, respectively). In NFBC1966, overweight or obesity, history of regular smoking, and the socio-economic status of farmers or manual workers increased the risk of CTS over follow-up (1997–2016). Of the self-reported occupational exposures, vibration to the hands was associated with double the risk of CTS. Smoking ten or less pack-years before the age of 31 increased the risk of UNE two-fold and smoking more than ten pack-years over five-fold over follow-up. Overweight or obesity, socioeconomic status, or gender did not increase the risk of UNE in the adjusted analyses. Successful prevention of CTS, UNE and radial neuropathies requires better recognition of their risk factors. This study established several risk factors for CTS, and revealed smoking as the most important risk factor for UNE.
|Tila||Julkaistu - 2019|
|OKM-julkaisutyyppi||G5 Tohtorinväitöskirja (artikkeli)|
- 3126 Kirurgia, anestesiologia, tehohoito, radiologia