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Surgical release of the pediatric trigger thumb
Daniel J Marek1, Franck Fitoussi, Deborah C Bohn
1Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN 55454, USA.
The Journal of Hand Surgery
|April 6, 2011
Summary
Surgical release is a safe and effective treatment for locked pediatric trigger thumb (PTT). This study found excellent outcomes and high surgeon preference for surgical intervention in locked cases.
Area of Science:
- Orthopedics
- Pediatric Hand Surgery
Background:
- Pediatric trigger thumb (PTT) has variable reported spontaneous recovery rates (24-66%).
- Previous studies suggested conservative management for PTT.
Purpose of the Study:
- To review surgical outcomes for PTT.
- To survey pediatric hand surgeons' treatment practices for PTT.
Main Methods:
- Retrospective review of 217 thumbs in 173 pediatric patients undergoing surgical release for PTT.
- Email survey of 27 pediatric hand surgeons on treatment preferences for locked and intermittently triggering thumbs.
Main Results:
- Postoperative range of motion significantly improved, with an average loss of 1° extension compared to 36° preoperatively.
- No major complications or recurrences were noted at an average follow-up of 4.2 years.
- 85% of surgeons would surgically release a locked PTT, while 52% would observe an intermittently triggering thumb.
Conclusions:
- Surgical release is a short, safe, and effective treatment for locked PTT.
- Specialty-trained hand surgeons prefer surgical release for locked PTT.
- Observation may be considered for intermittently triggering thumbs if asymptomatic.