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Prevalence of bifid median nerves and persistent median arteries and their association with carpal tunnel syndrome in a sample of latino poultry processors and other manual workers

Authors

  • Francis O. Walker MD,

    Corresponding author
    1. Department of Neurology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, USA
    2. Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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  • Michael S. Cartwright MS, MD,

    1. Department of Neurology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, USA
    2. Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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  • Jill N. Blocker MS,

    1. Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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  • Thomas A. Arcury PhD,

    1. Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
    2. Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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  • Jung IM Suk MD,

    1. Department of Neurology School of Medicine, Catholic University of Daegu, Daegu, South Korea
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  • Haiying Chen PhD,

    1. Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
    2. Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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  • Mark R. Schultz PhD,

    1. Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
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  • Joseph G. Grzywacz PhD,

    1. Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
    2. Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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  • Dana C. Mora MPH,

    1. Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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  • Sara A. Quandt PhD

    1. Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
    2. Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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  • This study was supported by the National Institute for Occupational Safety and Health (R01 OH9251).

ABSTRACT

Introduction

The prevalence of bifid median nerves and persistent median arteries, their co-occurrence, and their relationship to carpal tunnel syndrome (CTS) are only understood partially.

Methods

We screened 1026 wrists of 513 Latino manual laborers in North Carolina for bifid median nerves and persistent median arteries using electrodiagnosis and ultrasound.

Results

A total of 8.6% of wrists had a bifid median nerve, and 3.7% of wrists had a persistent median artery independent of subgroup ethnicity, age, gender, or type of work. An association with definite carpal tunnel syndrome was not found. The presence of either anatomic variant was associated with a high likelihood of co-occurrence of another variant in the same or the contralateral wrist.

Conclusions

The occurrence of median anatomic variants can be determined in field studies using ultrasound. Persistent median arteries and bifid median nerves tend to co-occur but do not put manual laborers at additional risk of developing CTS. Muscle Nerve 48: 539–544, 2013

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