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

Mechanism of Interneural Edema in Carpal and Cubital Tunnel

May 17, 2020

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…

Read More

Mirror therapy after a peripheral nerve repair in hand therapy

July 24, 2022

Rapid Review Paula, M. H., Barbosa, R. I., Marcolino, A. M., Elui, V. M., Rosén, B., & Fonseca, M. C. (2016). Early sensory re-education of the hand after a peripheral nerve repair based on mirror therapy: a randomized controlled trial. Brazilian journal of physical therapy, 20(1), 58–65. The Skinny: Therapy is often provided following an…

Read More

The Effectiveness of Manual Therapy Versus Surgery in Carpal Tunnel Syndrome

February 6, 2022

Fernández-de-las-Peñas, C., Cleland, J., Palacios-Ceña, M., Fuensalida-Novo, S., Pareja, J. A., & Alonso-Blanco, C. (2017). The effectiveness of manual therapy for carpal tunnel versus surgery on self-reported function, cervical range of motion, and pinch grip force in carpal tunnel syndrome: A randomized clinical trial. Journal of Orthopedic & Sports Physical Therapy, 47(3), 151–161. The…

Read More

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.