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Percutaneous release for trigger thumb in children under general and local anesthesia
Hsien-Chung Wang1, Gau-Tyan Lin
1Department of Orthopedic Surgery, Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Insights
Percutaneous release effectively treats pediatric trigger thumb, achieving a 90% success rate regardless of anesthesia type. This minimally invasive procedure offers a safe and reliable solution for children with trigger thumb.
Area of Science:
- Pediatric Orthopedics
- Minimally Invasive Surgery
Background:
- Trigger thumb in children is a common condition affecting hand function.
- Surgical intervention, specifically A1 pulley release, is often necessary for treatment.
Purpose of the Study:
- To evaluate the efficacy and safety of percutaneous release for pediatric trigger thumb.
- To compare outcomes between local and general anesthesia for this procedure.
Main Methods:
- Retrospective trial involving 33 children (40 trigger thumbs) treated between 1989 and 2003.
- Procedures performed under local or general anesthesia based on patient tolerance.
- Assessment of release success, recurrence, and residual deformity.
Main Results:
- A 90% overall success rate for percutaneous release was achieved, with no recurrence.
- Local anesthesia group: 23 of 26 trigger thumbs successfully released.
- General anesthesia group: only one unsatisfactory outcome.
- No statistically significant difference in outcomes between anesthesia types (p=0.66).
Conclusions:
- Percutaneous release is a highly effective and safe treatment for pediatric trigger thumb.
- The choice of anesthesia (local vs. general) does not significantly impact the success rate.
- The procedure leads to full extension and flexion without residual deformity.
Abstract:
A retrospective trial of percutaneous release for 40 trigger thumbs in 33 children under different types of anesthesia (general versus local) at a mean age of 2.5 years was conducted between February 1989 and March 2003. Based on the tolerance of the child and parents, 20 children were processed using local anesthesia at our office and 13 children were given general anesthesia. We recommend special manipulation to ensure complete release of the A1 pulley when general anesthesia is necessary. Of the 26 trigger thumbs in the local anesthesia group, 23 were successfully released. Only one patient in the general anesthesia group had an unsatisfactory outcome. Percutaneous surgery achieved a 90% successful release rate for trigger thumb in children, without recurrence. There was no statistical difference in the release of trigger thumbs with these two anesthetic procedures (p = 0.66). Overall, 37 trigger thumbs achieved full extension and flexion without any residual deformity following percutaneous release. Our results suggest that percutaneous release for trigger thumb is satisfactory, no matter which method of anesthesia is used.
