Carpal Tunnel Release: Outcomes of Pediatric and Adolescent
Filed under Diagnoses
Rapid Review. Outcomes of pediatric and adolescent carpal tunnel release based on etiology.
Velicki, K., Goldfarb, C. A., Roberts, S., & Wall, L. B. (2021). Outcomes of pediatric and adolescent carpal tunnel release. The Journal of Hand Surgery, 46(3), 178-186.
The Skinny: Less than 1% of pediatric carpal tunnel is idiopathic in nature, compared to adults where the majority of carpal tunnel is idiopathic. Limited studies have looked into the surgical outcomes of pediatric carpal tunnel release and there have been no studies comparing outcomes based on the etiology of symptoms.
In the Weeds: Twenty-three patients with 26 surgeries were enrolled in the study and grouped based on the etiology: All of these patients had hand median nerve pain or other symptoms such as numbness and tingling indicating carpal tunnel syndrome.
| Etiology | Number of Hands |
| Lysosomal storage disease | 11 hands |
| Idiopathic | 6 hands |
| Acute traumatic | 7 hands |
| Delayed traumatic | 5 hands |
| Tumorous | 2 hands |
Outcome measures included the Boston Carpal Tunnel Questionnaire (BCTQ), and Patient-Reported Outcomes Measurement Information System (PROMIS) scores.
Bringing it Home: The median age for surgery was 12.7 years (range 2.5 – 23.3). All patients with tumorous etiology and acute trauma had resolution of symptoms. Those with delayed and idiopathic etiology experienced recurrent symptoms. Patients with lysosomal storage disease all experienced the gradual return of their symptoms with 2 of the patients undergoing revision carpal tunnel release.
In acute cases, carpal tunnel release was very successful in relieving median nerve pain in the pediatric population, but not always in the delayed traumatic. Approximately 50% with idiopathic carpal tunnel experienced resolution of symptoms. With lysosomal storage disease, the patient experienced relief for a few years.
Rating ⅘
There were multiple limitations in the study including a limited number of participants in each category. There was also some diagnostic uncertainty, as some of the diagnosis was based on the clinician’s judgment. Lastly, phone interviews and chart reviews were utilized to obtain outcomes data, so there were various means utilized to obtain the data, in which the interviewer could have influenced the outcomes.
More To Read
Ways to Improve HEP Compliance in Hand Therapy
Ways to Improve HEP Compliance in Hand Therapy By: Dalton Busch One of the most important ways we see our patient’s progress is by assuring they are compliant with their prescribed home exercise program (HEP). Our patients are always encouraged to adhere to their prescribed program but compliance is easier said than done. Reminding patients…
Do you know the difference between an Electromyography (EMG) and a Nerve Conduction Velocity (NCV) Study?
Do you know the difference between EMG and NCV (an Electromyography and a Nerve Conduction Velocity Study? The term nerve test is usually a broad term that typically indicates both an Electromyography (EMG) and a Nerve Conduction Velocity (NCV) study (EMG vs NCV). An EMG looks at the electrical signals your muscle makes when at…
Test for Distal Radial Ulnar Joint of the Wrist
Ballottment Test for Wrist DRUJ Reliability and Validity Analysis of the Distal Radioulnar Joint Ballottement Test Nagashima, M., Omokawa, S., Hasegawa, H., Nakanishi, Y., Kawamura, K., & Tanaka, Y. (2024). Reliability and validity analysis of the distal radioulnar joint ballottement test. The Journal of Hand Surgery, 49(1), 15–22. https://doi.org/10.1016/j.jhsa.2023.10.006 The Skinny: Distal radioulnar joint (DRUJ)…
Assessments Seen in the Hand Therapy World
By: Dalton Busch Below I have created a list of some of the common assessments that are seen in the hand therapy world. Keep in mind that this list is not inclusive of all the assessments you might come across in this setting. With each assessment, I describe what it is, who the assessment is…
Sign-up to Get Updates Straight to Your Inbox!
Sign up with us and we will send you regular blog posts on everything hand therapy, notices every time we upload new videos and tutorials, along with handout, protocols, and other useful information.