The management of trigger thumb in children

Area of Science:

• Pediatric Orthopedics
• Hand Surgery
• Congenital Abnormalities

Background:

• Trigger thumb (stenosing tenosynovitis) is an uncommon condition in children.
• The current standard treatment involves prolonged observation.
• This approach may not always prevent the need for intervention.

Purpose of the Study:

• To evaluate the long-term outcomes of observation versus surgical intervention for congenital trigger thumb.
• To determine if delayed surgical release affects the final results.

Main Methods:

• Retrospective review of 41 patients with 53 affected thumbs.
• Analysis of treatment pathways, including observation periods and surgical interventions.
• Assessment of surgical outcomes after release of the flexor pollicis longus tendon.

Main Results:

• All 41 patients eventually required surgical release of the flexor pollicis longus tendon.
• A waiting period of up to 3 years before surgery did not negatively impact the surgical outcome.
• The condition appears to be self-limiting in terms of requiring surgical intervention.

Conclusions:

• Prolonged observation for congenital trigger thumb may not be necessary as surgical release is ultimately required for all patients.
• Delayed surgical release of the flexor pollicis longus tendon does not compromise the final outcome.
• Early surgical intervention should be considered for pediatric trigger thumb.