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
Comparing Edema and Lymphedema: Understanding the Differences and Treatment Approaches in Hand Therapy
Comparing Edema and Lymphedema: Understanding the Differences and Treatment Approaches in Hand Therapy As hand therapists we often encounter patients presenting with swollen arms, hands, and/ or fingers, often attributing these symptoms to various conditions. Two commonly confused terms in this area are “edema” and “lymphedema.” While both involve swelling, they have distinct causes, presentations,…
IFC vs TENS: Electrical Stimulation for Pain and Swelling
In this article we’re looking at the difference between Inferential Current versus Transcutaneous Electric Nerve Stimulation (IFC vs TENS). Transcutaneous Electric Nerve Stimulation (TENS) TENS variations are often described by their technical characteristics: high frequency, low intensity (conventional TENS) or low frequency, high intensity (acupuncture-like TENS, AL-TENS) (Walsh et al., 2009). How TENS Addresses Pain:…
Risk Factors for Complex Regional Pain Syndrome (CRPS) in Patients with Hand Trauma
Hand Trauma and CRPS in patients attending Hand Therapy By Tristany Hightower Savaş, S., İnal, E. E., Yavuz, D. D., Uslusoy, F., Altuntaş, S. H., & Aydın, M. A. (2018). Risk factors for complex regional pain syndrome in patients with surgically treated traumatic injuries attending hand therapy. Journal of Hand Therapy, 31(2), 250–254. https://doi.org/10.1016/j.jht.2017.03.007 The…
The Use of Neuromuscular Electrical Stimulation with Upper Extremity Paralysis
The Use of Neuromuscular Electrical Stimulation with Upper Extremity Paralysis By: Mikayla Murphy Martin, R., Johnston, K., & Sadowsky, C. (2012). Neuromuscular electrical stimulation–assisted grasp training and restoration of function in the tetraplegic hand: A case series. The American Journal of Occupational Therapy, 66(4), 471-477. https://doi.org/10.5014/ajot.2012.003004 The Skinny The purpose of the study was to…
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.