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Clinical analysis of the trigger thumb of childhood
Mustafa Herdem1, Hüseyin Bayram, Emre Toğrul
1Division of Hand Surgery, Department of Orthopedics and Traumatology, Cukurova University Faculty of Medicine, Adana, Turkey.
Insights
Surgical release is recommended for childhood trigger thumb (congenital trigger thumb) as conservative treatments under age three were unsuccessful. This intervention effectively resolved contractures and nodules in a seven-year follow-up.
Area of Science:
- Pediatric Orthopedics
- Hand Surgery
- Developmental Pediatrics
Background:
- Childhood trigger thumb, also known as congenital trigger thumb, affects the flexor pollicis longus tendon.
- The exact cause of this condition remains unknown.
- This study evaluates treatment outcomes for pediatric trigger thumb.
Purpose of the Study:
- To assess the effectiveness of different treatment modalities for trigger thumb in children.
- To determine the optimal treatment approach for pediatric trigger thumb.
- To propose a revised terminology for this condition.
Main Methods:
- Retrospective evaluation of treatment outcomes for 47 trigger thumbs in 36 children.
- Analysis of patient demographics including age at presentation and diagnosis.
- Comparison of conservative versus surgical treatment approaches.
Main Results:
- Conservative treatment was unsuccessful in all patients under three years of age.
- Surgical release was performed in all evaluated cases.
- Mean follow-up of seven years showed complete resolution of contractures and palpable nodules.
Conclusions:
- Surgical intervention is the preferred treatment for childhood trigger thumb.
- The term "developmental trigger thumb" is proposed as a more accurate descriptor than "congenital trigger thumb".
- Early surgical management leads to favorable long-term outcomes.
Abstract:
Trigger thumb of childhood, termed congenital trigger thumb, is a pathology of the flexor pollicis longus tendon with an unknown etiology. In this study, treatment outcomes of 47 trigger thumbs of 36 children were evaluated. There were 18 males and 18 females with a mean age of 34 months (9 months-13 years). Average age of recognition of pathology by the family was 20.5 months (0-8 years). In seven of 11 bilateral cases pathology was recognized simultaneously while in the other four, diagnosis was made at different times. We used conservative treatment for all patients under three years of age, which was unsuccessful. Thus, surgical relase was performed in all cases. In the mean follow-up of seven years (range 5-15), contracture and palpable nodules disappeared. In conclusion, we believe trigger thumb in childhood should be treated surgically and that the term "congenital trigger thumb" should be changed to "developmental trigger thumb".
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