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
Management of a TFCC Injury in Hand Therapy
By: Taylor Volentine The wrist is composed of very complex joints that assists with movement in individuals of all ages and abilities. For instance, an active individual who participates in sports such as tennis, football, or gymnastics may increase the probability for wrist complications and injury (Morrison, 2019). Individuals with repetitive trauma from work or…
Comparing the Rates of Recovery Among Four Common Shoulder Surgeries
Rapid Review By: Case Peters Comparing the Rates of Recovery Among Four Common Shoulder Surgeries Grubhofer, F., Martinez, A.R.M., Ernstbrunner, L., Haberli, J., Selig, M.E., & Warner, J.J. (2021) Speed of recovery of the most common performed shoulder surgeries. JSES International.5(4); 776-781. doi: 10.1016/j.jseint.2021.03.007 The Skinny: Setting realistic expectations for the trajectory of recovery is…
Should we still be immobilizing the thumb in scaphoid fractures, or is a wrist-only cast just as effective?
Article:Harper, K. J., Rees, Y., Tan, N. X., Li, H., Fonseca, E. A., Quach, P. G., Lee, G. S., Brayshaw, J.R., & McGarry, S. (2025). Determining the success of clinical outcomes for thumbimmobilization compared to no thumb immobilization in adult non-displaced, non-surgically managed scaphoid fractures: A systematic review. Hong Kong journal ofoccupational therapy. The Skinny:This study…
Shoulder Pain: The Effectiveness of Conservative Treatment
Reference: Steuri, R., Sattelmayer, M., Elsig, S., Kolly, C., Tal, A., Taeymans, J., & Hilfiker, R. (2017). Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement: a systematic review and meta-analysis of RCTs. British journal of sports medicine, 51(18), 1340–1347. https://doi.org/10.1136/bjsports-2016-096515 By: Tayler Roost The Skinny: This study…
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.