Carpal tunnel syndrome is infrequent in children. This article discusses five children with nine involved hands with the condition. The diagnosis was confirmed by electromyography. Three of the children had storage diseases, primary mucolipidosis. The fourth child presented with macrodactyly and hypertrophy of the median nerve was noted consistent with a lipofibrohamartoma. The fifth patient had no identifiable etiology for the carpal tunnel syndrome.
This article highlights that the most common cause of carpal tunnel syndrome in children remains mucolipidosis. Over 70% of the cases reported have been due to this underlying condition. In fact, children with mucolipidosis should be surveyed for underlying carpal tunnel syndrome. A less common cause in children is lipofibrohamartoma of the median nerve, which often presents with associated macrodactyly. Idiopathic carpal tunnel not associated with lysosomal storage disease or lipofibrohamartoma of the median nerve is particularly difficult to diagnose. Children do not comprehend the concept of numbness or tingling, which complicates the diagnosis. A lower threshold for electrodiagnostic studies may prevent continued nerve compression and muscle degeneration in these very rare cases.
J Pediatr Orthop