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
Carpal Fractures: A Brief Overview
Carpal fractures account for 8% of fractures in the upper extremity. The carpals are situated between the (distal radius and ulna) and the metacarpals. They make up the proximal row- Scaphoid, Lunate, Triquetrum, and Pisiform, the distal row- Trapezium, Trapezoid, Capitate, and Hamate. Here are some of the most common carpal bone fracture Scaphoid…
Effects of different stretching techniques for improving joint range of motion.
Reference: Oba, K., Samukawa, M., Abe, Y., Suzuki, Y., Komatsuzaki, M., Kasahara, S., Ishida, T., & Tohyama, H. (2021). Effects of Intermittent and Continuous Static Stretching on Range of Motion and Musculotendinous Viscoelastic Properties Based on a Duration-Matched Protocol. International journal of environmental research and public health, 18(20), 10632. https://doi-org.libproxy.nau.edu/10.3390/ijerph182010632 The Skinny: This study used a cross-over…
Top 5 Hand Therapy Toys for Kids
Many therapists in hand therapy clinics have a lot of tools for their adult patients, but may not have as many tools for the less common pediatric patient. With nearly 20 years experience in pediatrics, we’ve compiled a list of our top 5 picks for tools to use with pediatric patients in hand therapy. We…
Do you know the secret ingredient to recovering from an injury?
Do you know the secret ingredient to recovering from an injury? I will give you a hint it is 5 letters and begins with the letter S. SLEEP Have you ever asked yourself a question – does sleep help injuries heal? This is for you to share with your patients but also serve as a…
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.