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
Tennis Elbow and Graded Exercises
Lateral Elbow Pain with Graded Exercise Chronic tennis elbow with a supervised graded exercise protocol Özdinçler, A. R., Baktır, Z. S., Mutlu, E. K., & Koçyiğit, A. (2023). Chronic lateral elbow tendinopathy with a supervised graded exercise protocol. Journal of Hand Therapy, 36(4), 913–922. https://doi.org/10.1016/j.jht.2022.11.005 The Skinny: This study looked at the effectiveness of an…
Dorsal Scapular Nerve Entrapment and Thoracic Pain
Don’t Forget to Evaluate for Dorsal Scapular Nerve Entrapment By Delaney Wright If your patient presents with any upper thoracic pain, it is critical to take measures to evaluate for dorsal scapular nerve entrapment. In a study completed by Sultan et al. (2013), 55 patients with interscapular pain were evaluated clinically and via nerve conduction…
Ultrasound use for reducing pain: Does it work?
Ilter, L., Dilek, B., Batmaz, I., Ulu, M.A., Sariyildiz, M.A., Nas, K., & Cevik, R. (2015). Efficacy of pulsed and continuous therapeutic ultrasound in myofascial pain syndrome: A randomized controlled study. American Journal of Physical Medicine & Rehabilitation, 94(7), 547-554. https://doi.org/10.1097/PHM.0000000000000210 Review by: Megan Prather The Skinny- Ultrasound hand therapy – ultrasound has been determined…
How much pain should a patient have during and after therapy?
How much pain should a patient have during and after therapy? As we all know pain is somewhat subjective. It can be hard to determine how much pain a patient should experience with the type of injury as well as the type of therapy intervention and hand pain treatment. The saying of “no pain, no…
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.