Trigger Thumb in Pediatric Patients: A 20-Year Update.

Area of Science:

• Pediatric Orthopedics
• Hand Surgery
• Musculoskeletal Conditions

Background:

• Pediatric trigger thumb, also known as congenital trigger digit, affects young children.
• Understanding patient characteristics and management factors is crucial for effective treatment.

Purpose of the Study:

• To analyze pediatric trigger thumb patient characteristics over two decades.
• To identify factors influencing operative versus nonoperative management decisions.

Main Methods:

• Retrospective review of 381 patients (468 thumbs) evaluated between 2000 and 2021.
• Data collected included demographics, trigger thumb stage, treatment, and complications.
• Analysis by age groups (<2, 2-5, >5 years) and treatment subgroups.

Main Results:

• Average age at presentation was 3.1 years; 76% had stage IV trigger thumbs.
• 78% of patients underwent surgery, with younger children (<2 years) more likely to receive nonoperative management.
• Stage IV trigger thumbs with initial alternative treatment were more likely to proceed to surgery; overall complication rate was 5.3%.

Conclusions:

• Findings aid in counseling families regarding pediatric trigger thumb.
• Early surgical intervention is recommended for stage IV trigger thumbs when anesthesia is safe.
• This approach may offer better outcomes than observation or splinting for advanced cases.