Related Experiment Video
Updated: Aug 17, 2026
A Standardized Acupotomy Protocol For The Treatment of Tenosynovitis of Hand Flexor Tendons In Human Patients
Published on: May 26, 2026
Retrospective study of open versus percutaneous surgery for trigger thumb in children
Hsien-Chung Wang1, Gau-Tyan Lin
1Department of Orthopedic Surgery, Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Insights
Percutaneous release is a safe and effective alternative to open surgery for treating pediatric trigger thumb, offering a 90% success rate without recurrence. This minimally invasive approach provides comparable outcomes to traditional methods.
Area of Science:
- Pediatric Orthopedics
- Minimally Invasive Surgery
- Hand Surgery
Background:
- Trigger thumb in children traditionally requires open surgery if conservative methods fail.
- Percutaneous release is a well-established treatment for adult trigger finger but less studied in pediatric trigger thumb.
- This study evaluates percutaneous release as an alternative to open surgery for pediatric trigger thumb.
Purpose of the Study:
- To compare the efficacy and outcomes of percutaneous release versus open surgery for pediatric trigger thumb.
- To recommend percutaneous release as a potentially more appropriate treatment for pediatric trigger thumb.
Main Methods:
- A retrospective study analyzed 61 children (72 trigger thumbs) treated between 1984 and 2003.
- 32 thumbs underwent open surgery, and 40 underwent percutaneous surgery.
- A novel manipulation technique was used to confirm complete A1 pulley release, especially under general anesthesia for sensitive patients.
Main Results:
- Percutaneous release achieved a 90% success rate for pediatric trigger thumb, with no recurrences reported.
- No statistically significant difference in outcomes was observed between open and percutaneous release methods.
- 37 thumbs treated percutaneously regained full extension and flexion without residual deformity.
Conclusions:
- Percutaneous release is a satisfactory alternative to open surgery for pediatric trigger thumb.
- A specialized manipulation technique aids in ensuring complete A1 pulley release, particularly in sensitive children.
- The findings support the wider adoption of percutaneous release for pediatric trigger thumb.
Background:
Percutaneous release for trigger finger in adults is well established, but this is not so for trigger thumb in children. The traditional treatment for trigger thumbs in children, if conservative treatment has failed, is open surgery. The authors' aim is to recommend that percutaneous release may be more appropriate in the treatment of trigger thumb in children.
Methods:
The authors performed a retrospective study of open versus percutaneous release for trigger thumb in children with a mean age of 2.4 years from December of 1984 to March of 2003. The 61 patients with 72 trigger thumbs included 35 boys and 26 girls. Thirty-two trigger thumbs were treated using open surgery before February of 1989. More recently, 40 trigger thumbs were treated using percutaneous surgery. The authors recommended a new manipulation to examine whether the A1 pulley had completely released, while the sensitive patients were operated on under general anesthesia.
Results:
The percutaneous procedure yielded up to a 90 percent successful release of trigger thumb in children without recurrence. The outcome of releasing trigger thumbs using these two surgical techniques showed no statistically significant difference. Thirty-seven trigger thumbs treated with percutaneous re-lease were able to achieve full extension and flexion without any residual deformity.
Conclusions:
The authors developed a special manipulation to ensure complete release of the A1 pulley when general anesthesia is necessary in the cases of sensitive children and parents. The results suggest that percutaneous release for trigger thumb in children is a satisfactory alternative to open release.