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Pediatric Trigger Digit Presenting in the Setting of Trauma.
Kashyap Komarraju Tadisina1, Caitlin A Francoisse1, Gianfranco Frojo1
1From the Division of Plastic Surgery, Saint Louis University School of Medicine.
Annals of Plastic Surgery
|June 12, 2021
Summary
Pediatric trigger digit, often linked to trauma, frequently requires surgical A1 pulley release. Initial misdiagnosis and immobilization delays treatment, but surgery offers reliable outcomes.
Area of Science:
- Pediatric Orthopedics
- Hand Surgery
- Musculoskeletal Conditions
Background:
- Pediatric trigger digit etiology is not fully understood.
- A link between pediatric trigger digit and local hand trauma was observed.
- This study investigates trigger digit presentation, diagnosis accuracy, and treatment impact.
Purpose of the Study:
- To analyze trigger digit presentation in children.
- To evaluate the accuracy of initial diagnoses.
- To assess the impact of treatment strategies on outcomes.
Main Methods:
- Retrospective review of pediatric trigger digit cases from 2001-2015.
- Analysis of 22 patients with 26 affected digits.
- Review of presentation, diagnosis, and treatment pathways.
Main Results:
- 88% of cases involved trigger thumb; 12% involved small finger triggering.
- Patients presenting after trauma had a 67% misdiagnosis rate, delaying treatment by 60 days.
- 88% of patients initially treated with immobilization eventually required A1 pulley release.
Conclusions:
- Trigger digit in children may be multifactorial, with trauma playing a role.
- Trauma association can lead to misdiagnosis and delayed treatment.
- A1 pulley release is a safe and reliable surgical solution for pediatric trigger digit.
