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Multiple congenital bilateral trigger digits in a 2-year-old child: case report
V De Luna1, V Potenza, L Garro
1Department of Orthopaedic Surgery, University of Rome Tor Vergata, Rome, Italy.
Insights
Congenital trigger finger in children is rare. Surgical release effectively treated multiple bilateral trigger digits in a 2-year-old boy, resolving all symptoms after a year of physiotherapy proved insufficient.
Area of Science:
- Pediatric Orthopedics
- Hand Surgery
- Congenital Hand Anomalies
Background:
- Trigger finger (stenosing tenosynovitis) is uncommon in pediatric populations.
- Congenital trigger digits can present as isolated or multiple affected digits.
- Etiology in children is often idiopathic, without clear predisposing factors.
Purpose of the Study:
- To report a case of multiple congenital bilateral trigger digits in a young child.
- To evaluate the efficacy of surgical intervention for pediatric trigger finger.
- To discuss treatment options for congenital trigger finger in children.
Main Methods:
- A case study of a 2-year-old boy with multiple congenital bilateral trigger digits.
- Initial conservative management with physiotherapy for one year.
- Surgical release of affected digits followed by a 4-week extension brace post-operatively.
Main Results:
- Physiotherapy for one year did not resolve the symptoms of six trigger digits.
- Surgical release of the trigger fingers on the right hand, followed by the left hand, led to complete symptom resolution.
- No recurrence or complications were noted after surgical treatment and bracing.
Conclusions:
- Surgical release is an effective treatment for multiple congenital bilateral trigger digits in children.
- Conservative management with physiotherapy may be less effective for multiple or severe pediatric trigger digits.
- Early surgical intervention should be considered for persistent congenital trigger finger in pediatric patients.
Abstract:
Trigger finger is a rare condition in children. In this paper, we report on a 2-year-old boy with multiple congenital bilateral trigger digits. The patient had no history of perinatal trauma, viral or bacterial infections, or metabolic disorders. The patient was treated with physiotherapy for one year. At the one-year follow-up, the boy presented with six trigger fingers (3 on the right hand, 3 on the left hand). Neither thumb was involved. The six trigger fingers were treated surgically: first, the right-hand trigger fingers and, six months later, those of the left hand. After each operation, a 4-week brace in extension was applied to the operated hand. The symptoms were completely resolved after surgical treatment. Many authors have recommended surgical release for the treatment of trigger finger in children; empirical treatment with physiotherapy may be an option when symptoms present or appear at an older age.