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Extension splint for trigger thumb in children
Zhon-Liau Lee1, Chia-Hsieh Chang, Wen-Yi Yang
1Chang Gung Children Hospital, Taoyuan, Taiwan. jchase@lww.com
Insights
Splinting is an effective treatment for pediatric trigger thumb, with 71% of cases showing improvement or cure. This conservative approach is recommended before considering elective surgery for non-improved cases.
Area of Science:
- Pediatric Orthopedics
- Hand Surgery
- Musculoskeletal Disorders
Background:
- Trigger thumb (stenosing tenosynovitis) is a common condition in young children.
- Conservative management options are sought to avoid or delay surgical intervention.
Purpose of the Study:
- To evaluate the efficacy of extension splinting as a treatment for reducible pediatric trigger thumb.
- To compare splinting outcomes with observation alone.
Main Methods:
- A retrospective review of 62 reducible trigger thumbs in 50 children (0-4 years).
- Thirty-one thumbs were splinted for a mean of 11.7 weeks; 31 were observed.
- Outcomes (cured, improved, nonimproved) were assessed at a mean 20-month follow-up.
Main Results:
- The splinted group showed 71% (22/31) cured or improved outcomes.
- The observed group had only 23% (7/31) cured or improved outcomes.
- Nonimproved cases after splinting still had excellent results with subsequent surgery.
Conclusions:
- Extension splinting is a viable, effective treatment option for pediatric trigger thumb.
- Conservative splinting can be considered prior to elective surgical release.
- Surgical release remains a successful option for refractory cases.
Abstract:
Sixty-two reducible trigger thumbs in 50 children with age from 0 to 4 years (mean, 1 year 11 months) were reviewed to study the effect of splinting. Thirty-one thumbs in 24 children received splinting for a mean of 11.7 weeks. The other 31 thumbs in 26 children were only observed. The results were categorized as cured, improved, or nonimproved. Follow-up was conducted after a mean of 20 months (age, 43 months). Result in the splinted group showed cured in 12 thumbs, improved in 10 thumbs, and nonimproved in 9 thumbs, whereas in the observed group, result showed 4, 3, and 24, respectively. Splinting results in 71% trigger thumbs cured or improved that is better than observation alone. The subsequent surgical release for the nonimproved trigger thumbs after splinting still had excellent results. Because surgical release for trigger thumb is not urgent, we suggest extension splinting to be a treatment option before the elective surgery.
