[Ulnar neuropathy at the elbow in workers using column sewing machines: case reports and follow-up]

Fifteen cases of ulnar nerve neuropathy at cubital tunnel level were observed in women aged between 16 and 37 years employed in shoe factories. The women operated column sewing machines resting their elbows on the work table. Past evidence showed that the interval between the beginning of work and onset of neuropathy was generally more than one year but less than that for similar diseases observed in other jobs where arthritis of the elbow played a more important role and the average age was higher. It can therefore be supposed that arthritis in these shoes workers was of less significance, whereas local trauma, which was not prevented by the use of small soft cushions under the elbows (4 out of the 15 subjects had been using them for some time), seemed of greater importance. A period of less than one year (in one case only a few days) was deemed due to the presence of a pre-existing neuropathy of the elbow which had so far been asymptomatic. Cases treated within six months of onset showed marked improvement. However, rapidly worsening symptoms, independent of the degree of damage reached, often led to early treatment with favourable outcome in a short time, while slow and insidious onset brought a longer prognosis. The primary prevention suggested is to instruct workers as to the correct work posture, i.e., avoiding resting the elbows on the work table. As a secondary preventive measure, bearing in mind the need of early diagnosis and treatment, medical check-ups every six months are proposed.