Carpal Tunnel Release: Outcomes of Pediatric and Adolescent

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. 

carpal tunnel

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.

EtiologyNumber 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.  

Leave a Comment






More To Read

Phantom Limb Pain, Residual Limb Pain, & Phantom Limb Sensation: Which is Which?

November 15, 2020

Written by Melissa Miller Introduction After amputation, the majority of individuals will experience phantom limb pain (PLP), residual limb pain (RLP), and/or phantom limb sensation (PLS). Experiencing these pains or sensations can greatly disrupt an individual’s quality of life. It is important to know what each of these are as each can impact the client…

Read More

Putting Occupation in Hand Therapy

February 5, 2019

It was early in my career, maybe a year out of school. I was working with a veteran physical therapist that had been practicing for thirty plus years. She was somewhat intimidating and one of those old school physical therapists that thrived on being aggressive. We were chatting about what areas of occupational hand therapy…

Read More

Pediatric & Adolescent Shoulder Instability

July 5, 2020

Lin, K.M, James, E.W., Spitze, E. & Fabricant, P.D. (2018). Pediatric and adolescent anterior shoulder instability: Clinical management of first-time dislocators. Current opinion in pediatrics, 30, 49-56. doi: 10.1097/MOP.0000000000000566.  The Skinny: Shoulder instability for pediatric and adolescent patients is fairly common and is often complicated by a high re-dislocation rate. Shoulder instability typically occurs after…

Read More

Increasing Shoulder Range of Motion by improving Scapulohumeral Rhythm

September 15, 2019

Scapulohumeral rhythm is often the key component when treating shoulder conditions and the reason for the lack of total shoulder range of motion. This may also be a critical component in order to prevent shoulder conditions during rehabilitation of other upper extremity conditions such as distal radius fractures, tendon injuries, and elbow injuries. Scapulohumeral rhythm…

Read More
Envelope_1

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.