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Pediatric Trigger Finger due to Osteochondroma: A Report of Two Cases
Ricardo Kaempf de Oliveira1, Pedro J Delgado2, João Guilherme Brochado Geist3
1Santa Casa and Mãe de Deus Hospitals, Porto Alegre, Brazil.
Insights
Pediatric trigger finger in long digits, rare in children, can be caused by osteochondroma. Surgical resection of the bone tumor alongside pulley release successfully restored finger function.
Area of Science:
- Orthopedics
- Pediatric Surgery
- Hand Surgery
Background:
- Trigger finger involves painful blocking of finger flexor tendons at the A1 pulley.
- It is uncommon in children, typically affecting the thumb without a clear cause.
Observation:
- Two pediatric cases of trigger finger in long digits were caused by osteochondroma on the proximal phalanx.
- Both patients had juvenile multiple osteochondromatosis and presented with painful finger blocking.
Findings:
- Surgical intervention involved wide regional exposure, A1 and partial A2 pulley release, and osteochondroma resection.
- Patients experienced uneventful recovery with restored finger motion.
Implications:
- Pediatric trigger finger differs from adult cases and requires specific consideration based on digit involvement.
- A secondary cause, such as osteochondroma, must be investigated for trigger finger affecting long digits in children.
Abstract:
Background: The trigger finger is characterized by the painful blocking of finger flexor tendons of the hand, while crossing the A1 pulley. It is a rare disease in children and, when present, is usually located in the thumb, and does not have any defined cause. Methods: We report 2 pediatric trigger finger cases affecting the long digits of the hand that were caused by an osteochondroma located at the proximal phalanx. Both children held the diagnosis of juvenile multiple osteochondromatosis. They had presented at the initial visit with a painful finger blocking. Surgical approach was decided with wide regional exposure, as compared with the trigger finger traditional surgical techniques, with the opening of the A1 pulley and the initial portion of the A2 pulley, along with bone tumor resection. Results: Patients evolved uneventfully, and recovered the affected finger motion. Conclusion: It is important to highlight that pediatric trigger finger is a distinct ailment from the adult trigger finger, and also in children is important to differentiate whenever the disease either affects the thumb or the long fingers. A secondary cause shall be sought whenever the long fingers are affected by a trigger finger.
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