The carpal tunnel syndrome in children.

INTRODUCTION: Carpal tunnel syndrome (CTS) in children represents a complex challenge for the hand surgeon because of its rarity, poor patient cooperation, frequently associated malformation syndromes and mental retard, atypical symptoms and nuanced and poor sensitivity of instrumental tests. The most frequently associated causes with the CTS in children are rare congenital malformations and diseases, requiring an overall assessment of the young patient and a high degree of suspicion for the potentially associated canalicular syndrome. On the other hand, the associated syndromes may be the main ally for a diagnosis that starts from the knowledge of the literature and the surgeon's suspicion by observing the child wailing. Early diagnosis and decompression treatment is mandatory. MATERIALS AND METHODS: The authors report a case series of 26 children and analyze the etiology and diagnostic algorithms. Patient assessment was based on complete clinical examination and medical history collection of these young patients with the involvement of the family and educators. RESULTS: In all 26 patients treated, along an average period of 23 months (minimum 12, maximum 30), no signs of recurrence or persistence of median nerve disturbances were recorded. CONCLUSIONS: In conclusion, we believe that anamnesis, a careful physical examination and analysis of instrumental examinations, should be accompanied by a thorough knowledge of rare diseases in the context of congenital malformations. The carpal tunnel syndrome, while well known and treated by each orthopedic surgeon, reveals a mysterious aspect in the context of the "fabulous" world of childhood illnesses, even more difficult than rare congenital diseases.

Anomalous muscle belly of the flexor digitorum superficialis associated with carpal tunnel syndrome: case report.

A patient had a 10-year history of pain and swelling in the right wrist and palm. Carpal tunnel exploration showed anomalous muscle bellies of flexor digitorum superficialis II and III. The muscle bellies were excised. Postoperatively, the symptoms disappeared. Our case is compared with others in the literature.

Congenital carpal tunnel syndrome: case report of autosomal dominant inheritance and review of the literature.

Carpal tunnel syndrome (CTS) is unusual in childhood, and familial occurrence has been reported infrequently. A case of CTS in a seven-year-old boy, associated with abnormal thickening of the transverse carpal ligament and aplasia of the median nerve distal to this ligament, is described. Clinical, electrodiagnostic, and surgical findings are presented: all were consistent with absence of the median nerve distal to the transverse carpal ligament. Family history of CTS was positive in a pattern consistent with autosomal dominant transmission in three generations. Thickening of the transverse carpal ligament has been described, although infrequently, in childhood and familial CTS. Aplasia of the median nerve distally has not been reported in association with this anatomic abnormality. Case reports of familial CTS are reviewed, and other congenital anomalies which should be considered in the differential diagnosis of CTS in children and adults are discussed.

Congenital carpal tunnel syndrome. A case report.

A boy with bilateral idiopathic congenital carpal tunnel syndrome was first seen at the age 4 years 6 months. He presented with triggering of the finger flexors at the wrist, abnormal posturing of the fingers and inability to pinch on one side. The triggering was relieved by transection of the transverse retinaculum. Pinch was restored by a tendon transfer. There have been no previous reports of idiopathic carpal tunnel syndrome present since birth. The literature and case are reviewed.

Congenital carpal tunnel syndrome.

A case of congenital carpal tunnel syndrome associated with melorheostosis is described. The symptoms were lack of use of the hand since birth, hypotrophy of the fingers innervated by the median nerve, and severe atrophy of the thenar muscles. The total degeneration of the nerve in the carpal tunnel was successfully treated with a sural nerve graft.