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
Sensitivity and Specificity in Thoracic Outlet Syndrome (TOS) Tests in Hand Therapy
By: Mikayla Murphy Sensitivity and Specificity in Thoracic Outlet Syndrome (TOS) Tests in Hand Therapy Thoracic outlet syndrome (TOS) describes the compression of nerves, arteries, and veins as they pass through the thoracic outlet. Compression can occur at the interscalene triangle, the costoclavicular triangle, and the subcoracoid space (Physiopedia, n.d.). There are three types of…
Splinting Options for Stiff Finger Joints
Following an injury to the proximal interphalangeal joint, there is often a loss of range of motion, typically in both the flexion and extension planes. Therefore, we have compiled a list of helpful splinting options for stiff finger joints. To Improve PIP Joint Flexion Flexion Wrap with Elastic Tape (Coban): This is a very easy…
Tommy John Injury: Journey Back to Throwing after a UCL Injury
Anatomy of Ulnar Collateral Ligament (UCL) Originating on the anteroinferior surface of the medial epicondyle of the humerus and inserting onto the sublime tubercle of the ulna, the ulnar collateral ligament (UCL), also known as the medial collateral ligament (MCL), is crucial in providing support to the medial aspect of the elbow by restraining valgus…
Article Review: Trapeziectomy and LRTI: What can patients with CMC osteoarthritis expect 12 months after the procedure?
Janakiramanan, N., Miles, O., Collon, S., Crammond, B., McCombe, D., & Tham, S. K. (2021). Functional Recovery Following Trapeziectomy and Ligament Reconstruction and Tendon Interposition (Trapeziectomy and LRTI): A Prospective Longitudinal Study. The Journal of hand surgery, S0363-5023(21)00304-X. Advance online publication. https://doi.org/10.1016/j.jhsa.2021.04.036 The skinny: Patients with trapeziometacarpal (TMC) osteoarthritis who are candidates for a trapeziectomy and…
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.