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
Wound Healing in Hand Therapy
By: Maddie Mott Wound healing (healing hand therapy) involves a complex series of interactions between different cell types, cytokine mediators, and the extracellular matrix with its four basic stages including hemostasis, inflammation, proliferation, and remodeling (Mackay & Miller, 2003). Because successful wound healing requires adequate blood and nutrients to be supplied to the site of…
The Importance of Purposeful Activities Following Surgical Repair of a Distal RadiusFracture
By: Kelsey Melton Collis, J. M., Mayland, E. C., Wright-St Clair, V., Rashid, U., Kayes, N., & Signal, N.(2022). An evaluation of wrist and forearm movement during purposeful activities andrange of movement exercises after surgical repair of a distal radius fracture: A randomizedcrossover study. Journal of Hand Therapy. https://doi.org/10.1016/j.jht.2022.07.009 The Skinny: This randomized crossover study…
A Hand Therapist’s Role in Nutrition Education for Wound Healing
By Brittany Day Role of nutrition in wound healing Nutrition plays an important function in the biological factors that contribute to normal wound healing (wound care nutrition). Patients without nutrient dense diets may experience diminished cell production, collagen synthesis, and wound contraction. There is sparse scientific evidence that explores the exact science behind nutrition and…
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…
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.