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
Occupation Based Interventions in Hand Therapy
Keeping Occupation Based Interventions in Hand Therapy By: Tristany Hightower Are your treatments occupation based? Do you tailor your activity choices to fit the needs of each patient? As occupational therapists, we should be specialists in creating goals and interventions that are directed at returning our patients to meaningful occupations. Too often, hand therapy can…
Read More
10 Tips for Effective Learning for the CHT Exam
Learning to study effectively for the CHT exam is an essential first step to take while studying. We all learn and process information differently but implementing some strategies can lead to more effective learning and save countless hours. People always ask how many hours they should study per week. Unfortunately, there is no simple answer…
Read More
Prevention and Management of Upper Extremity injuries in Modern Mass Production
Injuries and Upper Extremty Pitts, G., Custer, M., Foister, R. D., & Uhl, T. (2021). The hand therapist’s role in the preventionand management of upper extremity injuries in the modern mass production industrial setting.Journal of Hand Therapy, 34(2), 237–249. https://doi.org/10.1016/j.jht.2021.04.019 By: Kaylen Kallander The Skinny: This study included four case studies to determine the impact…
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.