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
3 Common Reasons for Ulnar-Sided Wrist Pain and Non-Surgical Hand Therapy Treatment Options
3 Common Reasons for Ulnar Sided Wrist Pain
Mechanism of Interneural Edema in Carpal and Cubital Tunnel
Mechanism of Interneural Edema Over the last few weeks I have been learning about ultrasonic imaging and carpal tunnel syndrome. When reviewing carpal tunnel syndrome, I learned that intraneural edema is a common sign of compression injuries such as carpal tunnel and cubital tunnel. There are numerous causes of carpal tunnel syndrome, and every scenario…
A randomized clinical trial comparing early active motion programs: Earlier hand function, TAM, and orthotic satisfaction with a relative motion extension program for zones V and VI extensor tendon repairs
By Brittany Day Collocott SJ, Kelly E, Foster M, Myhr H, Wang A, Ellis RF. A randomized clinical trial comparing early active motion programs: Earlier hand function, TAM, and orthotic satisfaction with a relative motion extension program for zones V and VI extensor tendon repairs. Journal of Hand Therapy. 2019. doi:10.1016/j.jht.2018.10.003 The Skinny- This is…
Mirror Therapy
Mirror therapy has many implications for therapy and can be used to treat many diagnoses that commonly involve the upper extremity. These include some of the Neuro Conditions we highlighted last week including, Stroke and Focal Hand Dystonia. Btw, you can download a mirror therapy exercises pdf here for free. How long should the patient…
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.