Carpal Tunnel Release: Outcomes of Pediatric and Adolescent

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. 

carpal tunnel

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.

EtiologyNumber 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.  

Leave a Comment






More To Read

CMC Arthritis Orthosis in the Hand: Mechanics and Purpose

November 1, 2020

One of the most common diagnoses we see in hand therapy is osteoarthritis of the 1st carpo-metacarpal joint where the metacarpal articulates with the trapezium. Also known as basal joint arthritis (CMC arthritis), this causes pain, joint deformity, loss of strength and loss of function. Patients come to us looking for relief of symptoms and…

Read More

Effects of different stretching techniques for improving joint range of motion.

February 3, 2023

Reference: Oba, K., Samukawa, M., Abe, Y., Suzuki, Y., Komatsuzaki, M., Kasahara, S., Ishida, T., & Tohyama, H. (2021). Effects of Intermittent and Continuous Static Stretching on Range of Motion and Musculotendinous Viscoelastic Properties Based on a Duration-Matched Protocol. International journal of environmental research and public health, 18(20), 10632. https://doi-org.libproxy.nau.edu/10.3390/ijerph182010632 The Skinny: This study used a cross-over…

Read More

How to Improve HEP Adherence for Optimal Rehabilitation Outcomes

February 21, 2021

By Sophia Grimm A lack of adherence to home exercise programs in rehabilitation is a significant problem, with nonadherence estimates as high as 30-65% for general musculoskeletal conditions. This could have potentially detrimental effects on patients’ clinical rehabilitation outcomes as the success of certain medical interventions depends largely on patient adherence to advice and prescribed rehabilitation…

Read More
Envelope_1

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.