Current concepts in the management of pediatric trigger thumb

Abstract

Pediatric trigger thumb is an acquired flexion deformity of the interphalangeal (IP) joint. It presents most commonly as a fixed flexion deformity, but can present as intermittent triggering or even a fixed extension deformity. Roughly one-third of patients will develop bilateral trigger thumbs. Studies have shown that the deformity can resolve with time on its own, but prolonged deformity is concerning for permanent IP joint contracture and/or deviation and metacarpophalangeal (MCP) joint compensatory hyperextension. Treatment is controversial, ranging from observation, splinting and stretching, to surgical release of the A1 pulley. Surgery is considered the definitive treatment with low complication rates, although the timing of surgery is highly variable among surgeons.

Keywords

Congenital trigger thumb / pediatric trigger thumb / locked trigger thumb / congenital hand / pediatric hand

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