R L Kurland | Search PubMed

PubMed2001

Relationship of workers' compensation status and duration of preoperative carpal tunnel symptoms.

Carpal tunnel syndrome (CTS) is one of the most common work-related injuries and a leading cause of work disability. We studied patients from a single community who had carpal tunnel releases (CTRs), comparing duration of preoperative symptoms and severity of nerve dysfunction among workers compensation and nonworkers compensation recipients. Included in the study were 131 patients who had a total of 187 primary CTRs done by a single surgeon. Duration of preoperative symptoms was significantly longer for nonworkers compensation patients than for workers compensation patients (p < 0.01). A smaller proportion of workers compensation patients had severe electromyography (EMG) findings (p = 0.04), and a larger portion had borderline EMG findings. People with work-related CTS appear to receive surgical treatment for CTS earlier than people whose CTS is not related to work covered under workers compensation laws.

Adult↗

PubMed1993

Trends in the utilization of primary total hip arthroplasty, 1969 through 1990: a population-based study in Olmsted County, Minnesota.

Using the unique data resources of the Rochester Epidemiology Project, we identified the residents of Olmsted County, Minnesota, who underwent total hip arthroplasty (THA) between 1969, when this technique was introduced, and 1990. During this period, 735 residents underwent 859 primary THAs. An initial dramatic upsurge in utilization of THA soon after its introduction was followed by a lower rate of increase, to an age- and sex-adjusted rate of 59.9 per 100,000 person-years in 1987 through 1990. In Olmsted County, the procedure was used more often in women than in men, but men underwent THA at a younger age than did women. THAs were performed for various conditions of the hip, but the increased utilization during the last decade of the study was mainly attributable to its application in primary degenerative hip disease among patients (male more often than female) from a wider age range; utilization of THA for hip fractures decreased during the study period. Most THAs were of the cemented variety (86.1%); however, the rate of use of noncemented THAs, first performed in 1984, is increasing. The overall upward trend in Olmsted County was consistent with European data but less than the rate of increase observed for the United States as a whole between 1983 and 1987. Olmsted County utilization rates, if projected nationally, suggest a need for more than 139,000 primary THAs each year at an annual direct cost of more than $2.7 billion. An urgent need exists for detailed examination of national utilization patterns and clarification of the role of cementless implants and of THA for hip fractures.

Adult↗

PubMed1982

Child abuse.

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Adolescent↗