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Updated: May 4, 2026
Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
[Carpal tunnel syndrome in children. About 10 clinical cases]
A Leduc1, P Perrot1, M V Truffandier1
1Service de chirurgie plastique et reconstructrice, centre des brûlés, hôpital Jean-Monnet, CHU de Nantes, 44093 Nantes cedex 01, France.
Insights
Carpal tunnel syndrome is rare in children, often presenting with atypical symptoms. Early diagnosis and surgical treatment led to complete symptom recovery in all five pediatric patients studied.
Area of Science:
- Pediatric Neurology
- Hand Surgery
- Peripheral Neuropathy
Context:
- Carpal tunnel syndrome (CTS) is a prevalent neuropathy in adults but infrequently diagnosed in pediatric populations.
- This study investigates a series of ten pediatric CTS cases, highlighting the challenges in diagnosis and management.
- Understanding the pediatric CTS presentation is crucial for timely intervention.
Purpose:
- To describe the clinical characteristics, diagnostic approaches, and surgical outcomes of carpal tunnel syndrome in children.
- To emphasize the importance of early recognition and intervention for pediatric CTS.
- To evaluate the efficacy of open surgical treatment for pediatric carpal tunnel syndrome.
Summary:
- Five children (2 male, 3 female) with bilateral carpal tunnel syndrome were analyzed, with diagnoses including mucopolysaccharidosis, VATER association, and idiopathic cases.
- Symptoms presented atypically, with some children experiencing night pain or finger under-utilization and thenar atrophy.
- Open surgical release of the carpal ligament was performed, with electromyography used for diagnostic confirmation in four patients.
Impact:
- Surgical intervention resulted in complete resolution of pain, improved sensation, and restored thumb opposition in all pediatric patients.
- Prompt diagnosis and treatment are vital to prevent long-term functional deficits in children with CTS.
- This study underscores the effectiveness of surgical management for pediatric carpal tunnel syndrome, advocating for increased clinical vigilance.
Introduction:
The carpal tunnel syndrome is a common peripheral neuropathy in adults but is rare in children. We report a series of 10 carpal tunnel syndromes in children.
Methods:
We have supported five children, two males and three females, with a bilateral carpal tunnel syndrome. We studied the clinical history (history, symptoms, stage of disease), therapeutic management and remote development. Three children were diagnosed with a mucopolysaccharidosis, the fourth with VATER association. For the last child, it was a form considered idiopathic. Two children were referred for night pains, the others for under-utilization of their first three fingers, two of which had a thenar atrophy. Four children underwent an electromyogram for diagnostic confirmation. We realized open surgical treatment at one time, by section of the carpal ligament.
Results:
The average age of our patients was 4years. The average decline in the surgical study was 19 months. Postoperatively, we noted, in all patients, complete regression of the painful symptoms, a sensory improvement and recovery of the opposition of the thumb.
Conclusion:
The scarcity of carpal tunnel syndrome in children and the atypical symptoms may cause diagnostic delay, with serious consequences. We keep vigilant and ready to access to additional tests (electromyogram). For our team, the therapeutic approach is a systematic open surgical treatment.
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