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
Scapholunate Wrist Injuries in Hand Therapy
Scapholunate Wrist Injuries in Hand Therapy In outpatient hand therapy, we get a variety of referrals ranging from post-operative patients to those looking to avoid or prolong surgery. These referrals come from a variety of sources ranging from primary care doctors to experienced hand surgeons. The therapy orders can be vague to very specific. …
Does Obesity or Smoking change the outcomes for Distal Radius Fractures
Hall, Matthew J., Ostergaard, P., Dowlatshahi, A., Harper, C., Earp, B. Rozental, T. (2019). The Impact of Obesity and Smoking on Outcomes After Volar Plate Fixation of Distal Radius Fractures. The Journal of Hand Surgery. In Press, Corrected Proof, Available online 31 October 2019. Doi: https://doi.org/10.1016/j.jhsa.2019.08.017 The Skinny- Distal radius fractures are one of the…
Scar Wars: Scar Management Techniques
We will briefly discuss Scar Management Options and Techniques
Management of a TFCC Injury in Hand Therapy
By: Taylor Volentine The wrist is composed of very complex joints that assists with movement in individuals of all ages and abilities. For instance, an active individual who participates in sports such as tennis, football, or gymnastics may increase the probability for wrist complications and injury (Morrison, 2019). Individuals with repetitive trauma from work or…
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.