Median nerve compression in the carpal tunnel in children - a delayed diagnosis. About 20 clinical cases

• Published in: Annales de chirurgie plastique et esthétique 2021-08, Vol.66 (4), p.298-304
• Main Authors: Andre, E, Hamel, A, Perrot, P, Duteille, F
• Format: Article
• Language: eng ; fre
• ISSN: 1768-319X
• DOI: 10.1016/j.anplas.2021.04.003

OBJECTIVESThe carpal tunnel syndrome is rare in children. We performed a retrospective study of 10 children. The aim is to show that the diagnosis of carpal tunnel syndrome is difficult in children. PATIENTS AND METHODSWe identified all children with median nerve compression in the carpal tunnel between 2010 at 2020, managed in our service. RESULTSTen children with 20 hands included. There was different etiologies of carpal tunnel syndrome: 5 lysosomal storage diseases, 4 idiopathic carpal tunnel syndrome, 1 genodermatose, 1 Byler syndrome and 1 VACTERL syndrome. Common presenting symptoms were pain (five patients) and under use of fingers (five patients). Two children had opposition deficit of the thumb. We operated 19 hands. Median age at diagnosis was 4 years and 7 months. One children or 2 hands had a reanimation of opposition by tendinous transfer of flexor digitorum superficialis tendon of the ring finger. All children had a complete regression of the painful symptoms, a use improvement of fingers and recovery of the opposition of the thumb. CONCLUSIONThe diagnosis of carpal tunnel syndrome is difficult in children. It is common to be confronted with an advanced clinical symptoms. The atypical symptoms may cause diagnostic delay. Due to the quality of the clinical results obtained, we recommend open carpal tunnel release even when the diagnosis seems delayed. LEVEL OF EVIDENCEIV.