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
Pillar Pain After Carpal Tunnel Release Surgery
Pillar Pain After Carpal Tunnel Release Surgery Carpal tunnel release (CTR) surgery is a common procedure, with the majority of patients experiencing satisfaction with its outcomes. However, for some individuals, a temporary complication known as “pillar pain” may arise, affecting approximately 13% of those undergoing CTR. Pillar pain manifests in the thenar eminence and hypothenar…
7 Tips to Help your Patients Manage Hand Osteoarthritis
Introduction Osteoarthritis in the hands can be frustrating and debilitating. As a form of degenerative joint disease, it causes stiffness, pain, swelling, and reduced grip strength—making daily tasks like writing, opening jars, and typing feel exhausting. Fortunately, there’s a proven holistic approach centered on hand therapy for arthritic hands. This includes tailored exercises, targeted splinting,…
Carpal Tunnel Treatment: Splinting Only vs Splinting & Conservative Treatment
Short-term clinical outcome of orthosis alone vs combination of orthosis, nerve, and tendon gliding exercises and ultrasound therapy for treatment of carpal tunnel syndrome. Sim, Sze En et al. Journal of Hand Therapy, Volume 32, Issue 4, 411 – 416 The Skinny- Carpal tunnel syndrome (CTS) is the most common compression neuropathy. Compression of the…
What is Chronic Exertional Compartment Syndrome? Overview and Hand Therapy Treatment Ideas
Compartment syndrome is a condition characterized by increased pressure within a compartment of the body, leading to pain, swelling, and reduced tissue perfusion (Barkay et al., 2021; Buerba et al., 2019). It can be either acute or chronic (Barkay et al., 2021). Chronic exertional compartment syndrome (CECS) is a rare type, most commonly observed in…
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.