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|
|Acute traumatic||7 hands|
|Delayed traumatic||5 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.
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
“Do joint mobilizations assist in the recovery of lateral elbow tendinopathy? A systematic review and meta-analysis”
By Sophia Grimm Lucado, A. M., Dale, R. B., Vincent, J., & Day, J. M. (2019). Do joint mobilizations assist in the recovery of lateral elbow tendinopathy? A systematic review and meta-analysis. Journal of hand therapy : official journal of the American Society of Hand Therapists, 32(2), 262–276.e1. https://doi.org/10.1016/j.jht.2018.01.010 The Skinny: The purpose of this study was…Read More
Do you know the secret ingredient to recovering from an injury? I will give you a hint it is 5 letters and begins with the letter S. SLEEP Have you ever asked yourself a question – does sleep help injuries heal? This is for you to share with your patients but also serve as a…Read More
Use of Compression Gloves for Distal Radius Fractures Miller-Shahabar, I., Schreuer, N., Katsevman, H., Bernfeld, B., Cons, A., Raisman, Y., & Milman, U. (2018). Efficacy of compression gloves in the rehabilitation of distal radius fractures: Randomized controlled study. American Journal of Physical Medicine & Rehabilitation, 97(12), 904–910. By Brittany Carrie The Skinny Distal radius fractures are a…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.