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
Factors that influence orthosis adherence in patients with acute traumatic tendon injuries to the hand
Savaş, S., & Aydoğan, Ç. (2020). Factors affecting orthosis adherence after acute traumatic hand tendon repairs: A prospective cohort study. Journal of Hand Therapy, S0894113020301848. https://doi.org/10.1016/j.jht.2020.10.005 World Health Organization. (2003). Adherence to long-term therapies: evidence for action. World Health Organization. The Skinny Adherence to orthosis wear is vital for protecting healing tendons after a traumatic tendon…
Read More
6 of our Favorite Adaptive Equipment Tools for CMC Osteoarthritis
Individuals struggling with osteoarthritis of the 1st CMC joint usually have difficulty with daily activities and it can become very frustrating. Everyday tasks such as cutting food, opening containers, and donning a button up shirt can become painful and slow. The largest contributor to the overall function of our hand is the thumb. If the…
Read More
THUMB ABDUCTION IN PATIENTS WITH CMC ARTHRITIS? HOW DO YOU MEASURE?
Article Review THUMB ABDUCTION IN PATIENTS WITH CMC ARTHRITIS? HOW DO YOU MEASURE? Corey McGee PhD, OTR/L, CHT , Virginia O’Brien OTD, OTR/L, CHT , Jennifer Skye MS, OTR/L, CHT , Katherine Wall MOT, OTR/L , Thumb Carpometacarpal Palmar and CMC Radial Abduction in Adults with Thumb Carpometacarpal Joint Pain: Inter-rater Reliability and Precision of…
Read More
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.