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Conservative treatment for trigger thumb in children
H Watanabe1, Y Hamada, T Toshima
1Department of Orthopaedic Surgery, Yamanashi Medical College, Nakakomagun, Japan.
Insights
Conservative treatment, involving passive thumb exercises, proved highly effective for pediatric trigger thumbs. This approach achieved a 96% satisfactory outcome, suggesting its efficacy, particularly in earlier stages.
Area of Science:
- Pediatric Orthopedics
- Hand Surgery
- Conservative Management
Background:
- Trigger thumb (stenosing tenosynovitis) is a common condition in children.
- It can lead to pain, limited motion, and potential deformities if untreated.
- Conservative options are often explored before surgical intervention.
Purpose of the Study:
- To evaluate the effectiveness of conservative treatment for pediatric trigger thumbs.
- To assess outcomes based on disease stage and age.
- To compare conservative management with surgical indications.
Main Methods:
- A cohort of 48 children (60 trigger thumbs) underwent conservative treatment.
- Treatment consisted solely of passive range-of-motion exercises performed by parents.
- Patients were monitored for treatment adherence and outcomes.
Main Results:
- A 96% satisfactory outcome was observed in 58 treated thumbs.
- Complete recovery was achieved in 16 stage 2 thumbs and 8 stage 3 thumbs.
- Two patients (two thumbs) withdrew from treatment; four stage 3 thumbs showed no improvement.
Conclusions:
- Conservative treatment, specifically passive exercise, is effective for pediatric trigger thumb, especially in stage 2.
- Surgical intervention may be considered for stage 3 trigger thumb in children under 3 years to prevent flexion deformities.
Abstract:
Conservative treatment was performed for 60 trigger thumbs (19 right, 17 left, 12 bilateral) in 48 children (19 boys, 29 girls); the age at initial diagnosis ranged from 0 to 48 months old (mean 26 months). In this approach, only passive exercise of the affected thumb was performed by the mother. As a result, two patients (two thumbs) dropped out of treatment. Fifty-six thumbs out of 58 showed a satisfactory result (96%). Sixteen thumbs (in stage 2) and eight thumbs (in stage 3) showed completely recovery. Four thumbs (in stage 3) have not yet improved. In conclusion, we suggest that conservative treatment is effective for trigger thumbs in stage 2, while surgical therapy was thought to be indicated for stage 3 before the age of 3 years to avoid flexion deformity.