CLINICAL OUTCOMES OF PATIENTS UNDERGOING CORRECTION OF NEUROMUSCULAR SCOLIOSIS WITH A CONTROLLED HOSPITAL PROTOCOL – PRELIMINAR OUTCOMES

2021 ◽  
Vol 20 (4) ◽  
pp. 249-253
Author(s):  
Gabriela Alcalde Pereira ◽  
Caroline de Carvalho Garcia ◽  
Marcia Almeida Lima ◽  
José Carlos Baldocchi Pontin ◽  
Andrea Dias Lamas Mafra
Keyword(s):  
Retrospective Study ◽  
Surgical Correction ◽  
Neuromuscular Scoliosis ◽  
Complication Rates ◽  
Level Of Evidence ◽  
The Mean ◽  
Underlying Diseases ◽  
Level Hospital ◽  
Epidemiological Characterization

ABSTRACT Objectives: To identify the main hospital outcomes of patients undergoing surgical correction of neuromuscular scoliosis and to assess complication rates and achievement of mobility goals after the use of a managed protocol. Methods: This is a longitudinal, retrospective study, with data obtained six months after the application of a protocol in 103 patients of both sexes submitted to surgical correction of neuromuscular scoliosis, at a tertiary level hospital in São Paulo, between June and December 2018 (pre-protocol) and between May and September 2019 (post-protocol). Data from patients who had previously undergone other orthopedic spine surgeries were excluded. In addition to the data for epidemiological characterization of the underlying diseases, the clinical characteristics and complications were analyzed. Results: Of the 103 patients evaluated, there was a predominance of females (53.4%) and a mean age of 14.9 years. The most frequent diagnosis was cerebral palsy, the mean angle of curvature was 75°, and the most frequently observed comorbidities were lung diseases (25%). The protocol was partially adhered to by professionals and after its implementation, there was a significant decrease in pain and the systemic inflammatory response syndrome (SIRS), prevention of immobility and a low rate of infection. Conclusions: The use of a protocol focused on patients undergoing correction of neuromuscular scoliosis led to reduced complications of SIRS and reduced pain; kept the surgical site infection rate low, and prevented short-term immobility. Level of evidence III; Retrospective study.

scholarly journals Surgical management of neuromuscular scoliosis: approaches, pitfalls and outcomes

2020 ◽  
Vol 8 (2) ◽  
pp. 137-150
Author(s):  
Elsayed E. Negm ◽  
Vinay Saraph ◽  
Mohamed S. Said
Keyword(s):  
Neuromuscular Disorders ◽  
Parent Satisfaction ◽  
Family Satisfaction ◽  
Surgical Correction ◽  
Neuromuscular Scoliosis ◽  
Morbidity And Mortality ◽  
Functional Evaluation ◽  
Complication Rates ◽  
The Mean

Background. Scoliosis is a common problem among neuromuscular disorders with increased incidence of morbidity and mortality. The management of neuromuscular scoliosis (NMS) is complex and requires a cooperative multi-disciplinary team to provide meticulous perioperative care. Conservative treatment, such as bracing, can delay but not replace surgical correction. However, surgery has the risk of higher perioperative complication rates in this patient population. Aim. It is a retrospective study to evaluate clinical outcome, approaches, pitfalls in management of NMS patients undergoing surgical correction. Materials and methods. We retrospectively evaluated patients with NMS who underwent surgery for scoliosis from 2004 to 2018. Sixty-eight patients were included in the study after meticulous preoperative checkup. In most cases an single-pedicle screw construct was used, but in a few others a hybrid construct was used. A follow up was performed to make a clinical and radiological assessment and recorded all measurements and any complications. A telephone questionnaire was used for functional evaluation and patient/parent satisfaction with surgery. Only 52 patients could participate in the questionnaire. Results. The mean follow up period was 43.28 months, and the mean age at the time of surgery was 14.29 years. The mean preoperative Cobbs angle was 71.7, while that of final follow-up was 34.6. The mean Cobbs correction percentage was 53.25%. For correction of fixed pelvic obliquity 15, a sacropelvic extension was done in 60.29% of cases. Complications occurred in 39.71% of operated cases; chest related in 36.11% (of all complications), hardware-related 16.67%, visceral complications (as paralytic ileus) in 13.89%, decubitus ulcer and delayed wound healing in 13.89%, deep wound infection in 8.33%, CNS complications (as status epilepticus) in 8.33%, and death in 2.78% (one case). The results of the questionnaire indicated favorable functional outcomes and patient/family satisfaction with surgery. Conclusion. Despite the perioperative difficulties seen in patients with NMS, patients who had relatively higher postoperative morbidity and mortality, most patients/parents were satisfied with the results of the spinal deformity surgery. The patients/parents would recommend surgery to other patients with similar disorders.

Revisiting the Natural History of Chronic Scaphoid Nonunions: A Retrospective Study of 20 Cases

2021 ◽  
Author(s):  
J. Terrence Jose Jerome
Keyword(s):  
Retrospective Study ◽  
Natural History ◽  
Functional Outcome ◽  
Grip Strength ◽  
Scaphoid Nonunion ◽  
Proximal Pole ◽  
Degenerative Arthritis ◽  
Level Of Evidence ◽  
History Of ◽  
The Mean

Abstract Background The natural history of scaphoid nonunion is the development of degenerative arthritis. A lot of information is still unclear about this progression. The purpose of this study is to analyze patients with scaphoid nonunions who had not received any kind of treatment and to assess the functional outcome. Materials and Methods This is a retrospective study that analyzed the patients with chronic scaphoid nonunions between 2009 and 2019. None of the patients received any treatment. The age at the time of injury, examination, pattern of fracture, types of scaphoid nonunion, symptoms, and duration of nonunion were noted. Diagnosis was confirmed by radiographs, computed tomography (CT) scan, and magnetic resonance imaging (MRI). Scapholunate and radiolunate angles were recorded. Pain score, modified mayo wrist score, grip strength, range of movement, and the functional outcome of these scaphoid nonunions were analyzed. A statistical correlation between the scaphoid nonunion presentations and the functional outcome was assessed. Results The mean age of the patients was 62 years (range: 35–82 years.). There were 17 male and 3 female patients. There were 9 waist and 11 proximal pole scaphoid nonunions. The mean duration of scaphoid nonunion was 34 years (range: 10–62 years). None of the patients had avascular necrosis (AVN) of the proximal scaphoid. The age at examination, gender, side of injury, fracture pattern (waist/proximal pole), fracture displacement ≤ 1 mm or > 1 mm, nonunion duration, and radiographic arthritic parameters had no significant impact on the functional outcome. Conclusions Untreated chronic scaphoid nonunion leads to the development of degenerative arthritis over a period of years, which is still unpredictable. Most of the patients become aware of the nonunion following a precedent injury or other reasons. Most of the patients have fair/good functional outcome despite reduced range of movements and grip strength. Many do not favor surgical intervention in the course of nonunion. Chronic nonunions open a lot of unanswered questions. Clinical relevance There have been numerous studies on the treatment aspects of scaphoid nonunion, with little knowledge about certain people with nonunion who did not have any kind of treatment. The demographics, clinical findings, and radiological parameters do confirm the progression of these nonunion to arthritis, but most of them had fair-to-good outcome throughout their life. It opens our thinking about the real need of treatment in such nonunions and raises numerous questions about the disease. Level of evidence This is a Level IV study.

scholarly journals Epidemiological characterization of ophidian accidents in a Colombian tertiary referral hospital. Retrospective study 2004-2014

2018 ◽  
Vol 66 (2) ◽  
pp. 153-158
Author(s):  
Karen Sarmiento ◽  
Ivonne Torres ◽  
Mariana Guerra ◽  
Carolina Ríos ◽  
Carlos Zapata ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Referral Hospital ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Epidemiological Characterization

Introducción. En Colombia se presentan 5 000 casos de ofidismo anuales, un problema de salud pública que por manejo inadecuado provoca mortalidad en el 8% de los casos y discapacidad en el 10%.Objetivo. Describir las características clínicoepidemiológicas de los pacientes diagnosticados con accidente ofídico en un hospital de tercer nivel en Colombia.Materiales y métodos. Se realizó una revisión de las historias clínicas con diagnóstico de ofidismo del Hospital Universitario De La Samaritana Empresa Social del Estado, en el período 2004-2014, analizando la frecuencia en las variables asociadas a la mordedura de serpiente, el tratamiento previo y el manejo intrahospitalario.Resultados. Se revisaron 42 historias clínicas. Predominó el ofidismo en hombres agricultores, con mordedura en miembros inferiores y asistidos inicialmente por curanderos. 90% de los pacientes presentó sobreinfección, 30% tuvo cultivo de la herida, 74% recibió antibiótico, al 50% se les realizó fasciotomía y al 95.2% se le suministró antiveneno.Conclusiones. Se evidenció variabilidad en el manejo de los pacientes y discrepancia en la dosis de antiveneno y la clasificación de severidad del envenenamiento, alta incidencia de infecciones a pesar del esquema antibiótico y procedimientos quirúrgicos reevaluados en ofidismo. El manejo médico del accidente ofídico debe estar en continua actualización para disminuir discapacidad y mortalidad en los pacientes.

scholarly journals Is Allograft Reconstruction of the Medial Ulnar Collateral Ligament of the Elbow a Viable Option for Nonelite Athletes? Outcomes at a Mean of 8 Years

2020 ◽  
Vol 8 (10) ◽  
pp. 232596712095914
Author(s):  
Justin C. Kennon ◽  
Erick M. Marigi ◽  
Chad E. Songy ◽  
Chris Bernard ◽  
Shawn W. O’Driscoll ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Case Series ◽  
Ulnar Collateral Ligament ◽  
Ulnar Neuropathy ◽  
Complication Rates ◽  
Collateral Ligament ◽  
Level Of Evidence ◽  
Functional Scores ◽  
The Mean

Background: The rate of elbow medial ulnar collateral ligament (MUCL) injury and surgery continues to rise steadily. While authors have failed to reach a consensus on the optimal graft or anchor configuration for MUCL reconstruction, the vast majority of the literature is focused on the young, elite athlete population utilizing autograft. These studies may not be as applicable for the “weekend warrior” type of patient or for young kids playing on high school leagues or recreationally without the intent or aspiration to participate at an elite level. Purpose: To investigate the clinical outcomes and complication rates of MUCL reconstruction utilizing only allograft sources in nonelite athletes. Study Design: Case series; Level of evidence, 4. Methods: Patient records were retrospectively analyzed for individuals who underwent allograft MUCL reconstruction at a single institution between 2000 and 2016. A total of 25 patients met inclusion criteria as laborers or nonelite (not collegiate or professional) athletes with a minimum of 2 years of postoperative follow-up. A review of the medical records for the included patients was performed to determine survivorship free of reoperation, complications, and clinical outcomes with use of the Summary Outcome Determination (SOD) and Timmerman-Andrews scores. Statistical analysis included a Wilcoxon rank-sum test to compare continuous variables between groups with an alpha level set at .05 for significance. Subgroup analysis included comparing outcome scores based on the allograft type used. Results: Twenty-five patients met all inclusion and exclusion criteria. The mean time to follow-up was 91 months (range, 25-195 months), and the mean age at the time of surgery was 25 years (range, 12-65 years). There were no revision operations for recurrent instability. The mean SOD score was 9 (range, 5-10) at the most recent follow-up, and the Timmerman-Andrews scores averaged 97 (range, 80-100). Three patients underwent subsequent surgical procedures for ulnar neuropathy (n = 2) and contracture (n = 1), and 1 patient underwent surgical intervention for combined ulnar neuropathy and contracture. Conclusion: Allograft MUCL reconstruction in nonelite athletes demonstrates comparable functional scores with many previously reported autograft outcomes in elite athletes. These results may be informative for elbow surgeons who wish to avoid autograft morbidity in common laborers and nonelite athletes with MUCL incompetency.

scholarly journals CARACTERIZAÇÃO CLÍNICA E EPIDEMIOLÓGICA DA MASTITE PUERPERAL EM UMA MATERNIDADE DE REFERÊNCIA

2019 ◽  
Vol 10 (2) ◽  
Author(s):  
Thamirys De Carvalho Mota ◽  
Inez Sampaio Nery ◽  
José Diego Marques Santos ◽  
Danielle Machado Oliveira ◽  
Nicole Maria Brandim de Mesquita Alencar
Keyword(s):  
Retrospective Study ◽  
Elementary Education ◽  
Maternity Hospital ◽  
Capital City ◽  
Teenagers And Young Adults ◽  
Las Mujeres ◽  
Epidemiological Profile ◽  
Epidemiological Characterization ◽  
Puerperal Mastitis

Objetivo: analisar o perfil sociodemográfico e epidemiológico da mastite em mulheres internadas em uma maternidade pública no período de 2005 a 2011. Metodologia: estudo descritivo, documental e retrospectivo com abordagem quantitativa, abrangendo todos os casos de mulheres com mastite de 2005 a 2011 em uma maternidade de referência no Piauí. Resultados: as mulheres, em sua maioria, eram adolescentes e adultas jovens (61,5%), solteiras (36,4%), oriundas da capital (61,5%), com ensino fundamental completo (34,6%) e do lar (36,5%). Todas fizeram uso de antibioticoterapia, a maioria não apresentou recidiva (94,2%) e a principal complicação clínica foi o ingurgitamento mamário (67,3%). Conclusão: trata-se de uma patologia frequente que interfere significativamente no sucesso ou não da amamentação, tornando-se imperativo uma assistência de enfermagem com ênfase na educação em saúde por meio de orientações sobre boas técnicas de amamentação e prevenção da mastite.Descritores: Aleitamento Materno, Período Pós-Parto, Saúde da Mulher, Enfermagem.CLINICAL AND EPIDEMIOLOGICAL CHARACTERIZATION OF PUERPERAL MASTITIS IN A REFERENCE MATERNITYObjective: to analyze the sociodemographic and epidemiological profile of mastitis in women hospitalized in a public maternity hospital from 2005 to 2011. Methodology: descriptive, documental and retrospective study with a quantitative approach, covering all cases of women with mastitis from 2005 to 2011 in Reference Maternity in Piauí. Results: most of women were teenagers and young adults (61.5%), single (36.4%), from the capital city (61.5%), with complete elementary education (34.6%), and housewives (36.5%). They all used antibiotic therapy. The majority did not present recurrence (94.2%), and the main clinical complication was breast engorgement (67.3%). Conclusion: mastitis is a frequent pathology that significantly interferes with the success or failure in breastfeeding. Nursing assistance with an emphasis on health education through guidelines on good breastfeeding techniques and prevention of mastitis becomes imperative.Descriptors: Breastfeeding, Postpartum Period, Women’s health, Nursing.CARACTERIZACIÓN CLÍNICA Y EPIDEMIOLÓGICA DE LA MASTITE PUERPERAL EN UNA MATERNIDAD DE REFERENCIAObjetivo: analizar el perfil sociodemográfico y epidemiológico de la mastitis en mujeres ingresadas en una maternidad publica en el periodo de 2005 a 2011. Metodología: estudio descriptivo, documental y retrospectivo con abordaje cuantitativo, que abarca todos los casos de mujeres con mastitis de 2005 hasta 2011 en maternidad de referencia en el Piauí. Resultados: las mujeres, en su mayoría, eran adolescentes y adultas jóvenes (61,5%), solteras (36,4%), oriundas de la capital (61,5%), con educación fundamental completa (34,6%) y que eran dueñas de casa (36,5%). Todas hicieron terapia con antibióticos, la mayoría no presentó recidiva (94,2%) y la principal complicación clínica fue la congestión mamaria (67,3%). Conclusión: se trata de una patología frecuente y que interfiere significativamente en el suceso o no de la lactancia materna, se vuelve imperativo una asistencia de enfermería con enfoque en la educación en salud por medio de orientaciones sobre buenas técnicas de lactancia materna y prevención de la mastitis.Descriptores: Lactancia Materna, Periodo Posparto, Salud de la Mujer, Enfermería.

scholarly journals Intra operative assessment of the coronal balance in spinal deformity surgery : a technical note and retrospective study

2021 ◽  
Vol 87 (1) ◽  
pp. 175-179
Author(s):  
Thibault Dewilde ◽  
Sebastiaan Schelfaut ◽  
Sven Bamps ◽  
Matthias Papen ◽  
Pierre Moens
Keyword(s):  
Retrospective Study ◽  
Case Series ◽  
Technical Note ◽  
Coronal Alignment ◽  
Level Of Evidence ◽  
Coronal Balance ◽  
Scoliotic Deformity ◽  
Significant Difference ◽  
The Mean ◽  
The Right

Obtaining a spine that is well balanced after fusion for scoliotic deformity is primordial for the patients’ quality of life. A simple T-shaped instrument combined with standard intraoperative fluoroscopy can be of great help to evaluate the coronal alignment quickly. The aim of this study was to evaluate if a T-shaped device could predict the postoperative coronal balance. Before finalization of the rod fixation, the balance was checked by verifying the relationship between the T-shaped instrument and the upper instrumented vertebra (UIV), and final adjustments were made to correct the coronal balance. A retrospective study was conducted on 48 patients who underwent surgery to correct scoliotic deformity. Intraoperative and postoperative coronal alignment was measured independently by two observers. The mean intraoperative horizontal offset measured between T-shaped instrument and the center of the UIV was 1,69mm to the right with a standard deviation (SD) of 12,43 mm. On postoperative full spine radiographs, the mean offset between the centra sacral vertical line and the center of the UIV was 2,44mm to the left with a SD of 13,10mm. There is no significant difference in coronal balance between both measurements (p=0,12). With this technique we were able to predict the postoperative coronal balance in all but one patient (97,92%). We conclude that the use of a simple T-shaped instrument can provide adequate intraoperative assessment of coronal balance in correcting scoliotic deformity. Level of evidence : IV – case series

scholarly journals Syndesmosis assessment in postoperative patients subjected to surgical treatment of supra-syndesmotic fracture

2018 ◽  
Vol 12 (4) ◽  
pp. 276-83
Author(s):  
Marcelo De Brito Teixeira ◽  
Gabriel Souza Albuquerque ◽  
Clauser Roberto Souza Lima Segundo ◽  
Felipe Rodrigues Santos Carneiro ◽  
Janice Souza Guimarães ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Period ◽  
Articular Surface ◽  
Contralateral Side ◽  
Normal Range ◽  
Level Of Evidence ◽  
Radiographic Images ◽  
Reproducible Method ◽  
The Mean ◽  
Additional Value

Objective: To demonstrate the patterns of syndesmosis reconstruction in ankle fractures via the measurement of pre-established and universally accepted parameters. Methods: In a retrospective study, fractures with radiographic images obtained during the postoperative period showing fixation of the distal tibiofibular syndesmosis were selected. After this selection, fracture reduction and syndesmosis fixation were evaluated by measuring radiographic parameters in the selected cases. Results: Twenty-three patients (63.8%) were male. Fourteen fractures (38.8%) were operated on by a senior surgeon (foot and ankle specialist). All syndesmoses were fixed with only 1 screw, and 35 patients (97.2%) had syndesmosis fixation involving 3 cortices. The mean syndesmosis fixation height from the articular surface was 2.20cm. Four fractures (11.1%) presented radiographic signs of medial ligament reconstruction. Regarding measurement of the tibiofibular space, in the anteroposterior (AP) view, 33 patients (91.6%) had values within the normal range. Regarding the tibiofibular overlap, in the AP view, 19 patients (52.7%) had measurements with values greater than 10mm (normal). In the evaluation of tibiofibular overlap, in the true AP view, all patients (100%) presented measurements greater than 1mm (normal). Regarding the measurement of the talocrural angle, only 1 patient did not have normal parameters. Regarding the medial clear space, only 2 patients (5.5%) had values above normal during the postoperative period. Conclusion: The adoption of objective parameters, in a standardized manner and relative to the contralateral side, adds additional value to the evaluation and ensures an accessible and reproducible method for the evaluation of these injuries. Level of Evidence II; Prognostics Studies; Retrospective Study.

Intermediate-term Experience With the STAR Total Ankle in the United States

2018 ◽  
Vol 40 (3) ◽  
pp. 268-275 ◽  
Author(s):  
Evan M. Loewy ◽  
Thomas H. Sanders ◽  
Arthur K. Walling
Keyword(s):  
United States ◽  
Perioperative Complications ◽  
Case Series ◽  
Major Complication ◽  
The United States ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Patient Reported ◽  
The Mean

Background: Limited intermediate and no real long-term follow-up data have been published for total ankle arthroplasty (TAA) in the United States. This is a report of clinical follow-up data of a prospective, consecutive cohort of patients who underwent TAA by a single surgeon from 1999 to 2013 with the Scandinavian Total Ankle Replacement (STAR) prosthesis. Methods: Patients undergoing TAA at a single US institution were enrolled into a prospective study. These patients were followed at regular intervals with history, physical examination, and radiographs; American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Scale scores were obtained and recorded. Primary outcomes included implant survivability and functional outcomes scores. Secondary outcomes included perioperative complications such as periprosthetic or polyethylene fracture. Between 1999 and 2013, a total of 138 STAR TAAs were performed in 131 patients; 81 patients were female. The mean age at surgery was 61.5 ± 12.3 years (range, 30-88 years). The mean duration of follow-up for living patients who retained both initial components at final follow-up was 8.8±4.3 years (range 2-16.9 years). Results: The mean change in AOFAS Ankle-Hindfoot scores from preoperative to final follow-up was 36.0 ± 16.8 ( P < .0001). There were 21 (15.2%) implant failures that occurred at a mean 4.9 ± 4.5 years postoperation. Ten polyethylene components in 9 TAAs (6.5%) required replacement for fracture at an average 8.9 ± 3.3 years postoperatively. Fourteen patients died with their initial implants in place. Conclusion: This cohort of patients with true intermediate follow-up after TAA with the STAR prosthesis had acceptable implant survival, maintenance of improved patient-reported outcome scores, and low major complication rates. Level of Evidence: Level IV, case series.

scholarly journals One versus two adjacent interdigital neuroma excision: a patient outcome study

2021 ◽  
Vol 15 (3) ◽  
pp. 236-240
Author(s):  
Kefilwe Boineelo Benjamin ◽  
Nikiforos Saragas ◽  
Paulo Ferrão
Keyword(s):  
Patient Outcome ◽  
Patient Satisfaction ◽  
Retrospective Study ◽  
The Self ◽  
Outcome Study ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Significant Difference ◽  
The Mean ◽  
Good For

Objective: We aimed to evaluate patient satisfaction after surgery for both single and two adjacent neuromas. Methods: We reviewed the data of patients treated operatively for interdigital neuromas between 2003 and 2016. We interviewed them and administered the Self-Reported Foot and Ankle Score questionnaire. Patient scores were then analyzed categorically, and variation between groups was assessed. Results: Sixty-two patients were available for review. Thirty-one patients had a single interdigital neuroma excised and 31 had two adjacente interdigital neuromas excised. Twenty-eight of the 31 (90%) patients with a single neuroma had good or excellent results while 23 (74.2%) of those with adjacent neuromas had similar outcomes. One patient with a single neuroma had a poor result while four patients with adjacent neuromas had poor results. The mean score was 41 (excellent) for patients with a single interdigital neuroma and 37 (good) for those with adjacent neuromas (p=0.473). The majority of patients in both groups would undergo surgery again. Conclusion: We found no statistically significant difference in outcomes of patients who undergo surgery for either single or two adjacent interdigital neuromas. General patient satisfaction is good and/or excellent post excision. Level of Evidence II; Prognostic Studies; Retrospective Study.

Carpal tunnel syndrome and finger deformities in children with mucopolysaccharidoses and mucolipidoses: a retrospective review of 52 patients

2021 ◽  
pp. 175319342110619
Author(s):  
Clément Thirache ◽  
Mathilde Gaume ◽  
Cyril Gitiaux ◽  
Arielle Salon ◽  
Caroline Dana ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Signs ◽  
Single Centre ◽  
Level Of Evidence ◽  
Age At Surgery ◽  
Tunnel Syndrome ◽  
The Mean

This single-centre retrospective study reports our management of carpal tunnel syndrome in 52 children (103 hands) with mucopolysaccharidoses and mucolipidoses. All except one were bilateral. The median age at surgery was 4 years (range 1.5 to 12). The diagnosis of carpal tunnel syndrome was confirmed by an electromyogram (EMG) in all patients; 38% of these presented without any clinical signs. Surgical neurolysis was performed in all hands, combined with epineurotomy in 52 hands (50%) and flexor tenosynovectomy in 75 hands (73%). Surgery was bilateral in 98% of children (102 hands). The mean follow-up was 12 years (range 1 to 19) and the EMG was normalized in 78% of hands. Ten patients suffered recurrence, eight of whom required further surgery. Screening for carpal tunnel syndrome is essential for the management of children mucopolysaccharidoses and mucolipidoses. Surgical treatment should be carried out early with follow-up by EMG to detect recurrence. Level of evidence: IV

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