ARTERIOPATHIES OF OCCUPATIONAL-DISEASES

Arteriopathies of occupational diseases predominate in the upper limbs and are usually expressed as Raynaud's phenomenon (<< white finger >>), sometimes complicated by digital gangrene. Hand-arm vibration disease, hypothenar hammer syndrome, exposure to silica even without silicosis and vinyl chloride intoxication are the principal causes of occupational diseases acknowledged as such by the laws. In a personal series of 60 patients with complicated upper limb arteropathies, 25 % had a recognized occupational disease. Since December 1992, Erasmus' syndrome and systemic scleroderma due to silicia without silicosis have been accepted in France as being occupational diseases. The therapeutic problems are discussed, notably the surgical indications in hypothenar hammer syndrome, the possible medical treatments of finger necrosis occurring in Erasmus' syndrome and, in particular, the role played by spinal cord neurostimulation.