Post-traumatic carpal tunnel syndrome in children

• Published in: Journal of the Pediatric Orthopaedic Society of North America 2024-05, Vol.7, p.100027, Article 100027
• Main Authors: Lee, Julianna, Buttrick, Eliza, Shah, Apurva S.
• Format: Article
• Language: English
• Subjects: Carpal tunnel syndrome; Pediatrics; Trauma
• ISSN: 2768-2765; 2768-2765
• DOI: 10.1016/j.jposna.2024.100027

Background: Given limited information about acute carpal tunnel syndrome (CTS) in children, the purpose of this study is to describe the presentation and treatment results of CTS after traumatic wrist or forearm injury in a pediatric population. Methods: In this retrospective single-center cohort study, all children with post-traumatic CTS were identified. Demographic and clinical presentation, treatment, and outcomes data were collected from the electronic medical record. Descriptive statistics were calculated for variables of interest, and Χ2 and independent sample t-tests were used for subgroup comparisons. Results: 18 patients (16 male, average age 12.8 ± 3.6 years) with post-traumatic CTS were identified. 13 presented acutely (6 weeks) after injury. Of associated traumas, 83% (15/18) involved distal radius fractures, of which 40% (6/15) had an associated ulna fracture. The most common symptoms were numbness (78%), paresthesias (33%), and increasing pain (28%). Three patients had clinical concerns for concomitant compartment syndrome. 6 patients were initially monitored (2 acute, 3 subacute, 1 delayed). Ultimately, 16/18 underwent operative release (13/13 acute, 2/4 subacute, 1/1 delayed). At follow-up, 81% of the surgically treated patients had complete symptomatic relief. There was no statistically significant difference in treatment outcomes between acute versus subacute or delayed presentation (OR: 6.67, p = .214). Of patients with acute CTS, delayed surgery resulted in prolonged recovery (28.0 vs. 2.4 weeks, p