Severe Osteoarthritis of the Elbow in Foundry Workers

Abstract
Foundry workers who used tongs for lifting and twisting metal rods develop severe osteoarthritis (OA) of the elbows. The main symptom was limitation of motion with an average loss of 45° for extension, 60° for flexion, 20° for pronation, and 10° for supination. Spontaneous pain was characteristically absent, and radiological changes were those of degenerative joint disease. A new mechanism of OA of the elbow is proposed: an increase in the length of the arm lever renders it less efficient and requires greater force which results in increased tangential (shearing) friction on the joint cartilages, and leads to early and progressive derangement of the joint. This should be considered an occupationally related disability.

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