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Paediatric Trigger-Locked Thumb.

Carlton Fernandes1, Katherine Dong2, Ghazi Rayan3

  • 1Department of Orthopedic Surgery, University of Oklahoma Health Sciences, Oklahoma City, Oklahoma, US.

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|February 23, 2022
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Summary

Paediatric trigger-locked thumb (PT-LT) is a common condition causing thumb flexion deformity. Treatment varies based on age, presentation, and type, including observation, splinting, therapy, or surgery.

Keywords:
ChildCongenital trigger thumbLocked thumbTrigger finger disorderTrigger thumb

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Area of Science:

  • Orthopedics
  • Pediatric Hand Surgery

Background:

  • Paediatric trigger-locked thumb (PT-LT) is a frequent pediatric thumb condition.
  • It involves an acquired flexion deformity of the interphalangeal joint due to tendon-pulley size discrepancy.

Purpose of the Study:

  • To describe the clinical presentation, classification, and treatment of paediatric trigger-locked thumb.
  • To provide an overview of management strategies for this condition.

Main Methods:

  • Classification of paediatric locked thumb into Type I (no MCPJ hyperextension) and Type II (with MCPJ hyperextension).
  • Review of treatment modalities including observation, splinting, therapy, and surgical intervention.

Main Results:

  • PT-LT can present as a locked or trigger thumb.
  • Surgical treatment involves pulley release, specifically the A1 and oblique pulleys.

Conclusions:

  • Treatment decisions for PT-LT are individualized based on patient factors and condition type.
  • Effective management strategies range from conservative measures to surgical release of the affected pulleys.