Outcomes of Pediatric and Adolescent Carpal Tunnel Release

Velicki, Katherine; Goldfarb, Charles A.; Roberts, Summer; Wall, Lindley B.

doi:10.1016/j.jhsa.2020.09.009

Cited by 8 publications

(4 citation statements)

References 34 publications

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“…CTS is very rare in children and adolescents. Differential diagnosis should pay attention to lysosomal storage disease, wrist trauma, carpal tunnel space-occupying lesions, etc., which are more common in children and adolescents with CTS ( 2 , 32 ). In addition, we thought that it should be differentiated from Congenital thenar hypoplasia and Hirayama disease, especially when only thenar atrophy and weakness are present.…”

Section: Discussionmentioning

confidence: 99%

“…CTS in children and adolescents is rare and mostly secondary to various hereditary diseases, such as lysosomal storage disease, including mucopolysaccharidoses(MPS) and mucolipidoses (ML) ( 1 ). Furthermore, wrist anatomical variations, wrist trauma, and localized masses may also contribute to carpal tunnel syndrome ( 2 ). Although anatomical variations of the wrist are not uncommon in clinical, only some individuals experience symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Coexistence of anomalous muscle, persistent median artery, bifid median nerve causing carpal tunnel syndrome: A case report and literature review

Qin

Tan²,

Xue³

et al. 2023

Front. Pediatr.

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Carpal tunnel syndrome (CTS) is an upper extremity median nerve entrapment disorder that is rare in children and adolescents. Anatomical variations of the wrist, such as anomalous muscles, persistent median artery (PMA), and bifid median nerves (BMN), are rare etiology of CTS. Coexistence of all three variants combined with CTS in adolescents has been rarely reported. Case description: A 16-year-old right-hand dominant male presented to our clinic with several years of bilateral thenar muscle atrophy and weakness but no paresthesia or pain in his both hands. Ultrasonography showed that the right median nerve become significantly thinner, and the left median nerve was split into two branches by PMA. Magnetic resonance imaging (MRI) revealed that anomalous muscles in the bilateral wrist extending to the carpal tunnel, causing compression of the median nerve. Considering the possibility of CTS clinically, the patient underwent bilateral open carpal tunnel release without resection of anomalous muscles and PMA. The patient has no discomfort after 2 years. This suggests that anatomical variations of the carpal tunnel may contribute to CTS, which can be confirmed by preoperative ultrasonography and MRI, and the possibility of carpal tunnel anatomical variations should be considered when CTS occurs in adolescents. Open carpal tunnel release is an effective treatment for juvenile CTS without the need to resect abnormal muscle and PMA during the operation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Coexistence of anomalous muscle, persistent median artery, bifid median nerve causing carpal tunnel syndrome: A case report and literature review

Qin

Tan²,

Xue³

et al. 2023

Front. Pediatr.

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“… 4 A recent study reported pediatric patients with metabolic disease who are experiencing recurrent CTS. 8 The mean age of initial diagnosis of CTS in MPS patients is 3–11 years. 3 The current literature supports early surgical management for MPS patients and does not recommend conservative management because delayed surgeries have correlated with a poor outcome.…”

Section: Discussionmentioning

confidence: 99%

Early Recurrent Carpal Tunnel Syndrome in Patients with Mucopolysaccharidoses

Park

Tai

Rahgozar

2021

Plastic and Reconstructive Surgery - Global Open

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“…Carpal tunnel syndrome in children is rare but does occur 19 . Velicki et al 20 reported long-term follow-up on pediatric patients after carpal tunnel release. Patients with acute and tumorous etiologies had full resolution of symptoms, and those with delayed traumatic and idiopathic etiologies such as lysosomal storage diseases often had recurrent or recalcitrant symptoms.…”

Section: Carpal Tunnel Syndromementioning

confidence: 99%

What’s New in Hand and Wrist Surgery

Bohn

Wise

2022

Journal of Bone and Joint Surgery

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The intent is to serve as an update of the hand surgery literature for the practicing general orthopaedic surgeon. Carpal Tunnel SyndromeCarpal tunnel syndrome is one of the most common disorders in hand surgery. Nevertheless, the optimum method for diagnosis remains controversial. A growing body of evidence suggests that electrodiagnostic studies [1][2][3][4] are not more sensitive and specific than diagnosis by ultrasound or clinical history and examination. D'Auria et al. 5 examined the role of electrodiagnostic studies compared with clinical judgment and found that the utility of electrodiagnostic studies may be greatest in patients for whom a diagnosis of carpal tunnel syndrome is questionable. Even so, electrodiagnostic studies are performed in many patients with carpal tunnel syndrome 6 . Less expensive, office-based diagnostic tools such as the Carpal Tunnel Syndrome 6 (CTS-6), a 26-point scale that incorporates aspects of the history and clinical examination to predict the probability of carpal tunnel syndrome, and ultrasound will likely supplant the routine use of electrodiagnostic studies for carpal tunnel syndrome.Strong evidence exists for the use of night splints and corticosteroid injections for early treatment of carpal tunnel syndrome. In a comparison of the 2 treatments, 100 patients with a diagnosis of carpal tunnel syndrome were randomized to a night splint or a corticosteroid injection 7 . In the 95 patients who completed follow-up, corticosteroid injections were superior in terms of nocturnal paresthesias, pain, and Boston Carpal Tunnel Questionnaire (BCTQ) function and symptom domains at 1, 3, and 6 months.A novel study on hand function with decreased sensation showed that a digital nerve block to the thumb had the greatest negative impact on dexterity and a loss of sensation in the index and long fingers caused decreased grip and chuck pinch strength, thus explaining the common symptoms of decreased dexterity and strength in patients with carpal tunnel syndrome 8 .Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/G899).

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Outcomes of Pediatric and Adolescent Carpal Tunnel Release

Cited by 8 publications

References 34 publications

Coexistence of anomalous muscle, persistent median artery, bifid median nerve causing carpal tunnel syndrome: A case report and literature review

Coexistence of anomalous muscle, persistent median artery, bifid median nerve causing carpal tunnel syndrome: A case report and literature review

Early Recurrent Carpal Tunnel Syndrome in Patients with Mucopolysaccharidoses

What’s New in Hand and Wrist Surgery

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