[Funtional Outcomes of Pediatric Trigger Digits - Outcomes of Two Centers]
Martin Vlach1,2, David Máška1, Alena Schmoranzová2
1Klinika detske a dospele ortopedie a traumatologie 2. lekarske fakulty Univerzity Karlovy a Fakultni nemocnice v Motole, Praha.
Purpose Of The Study:
The study evaluates the functional outcomes of the treatment of pediatric trigger digits in two centers and compares them with data from the available literature. The secondary objective is to verify the possibilities of collecting data on patients' health status through questionnaire surveys using remote communication via a web interface.
Material And Methods:
Patients operated on at the Hand and Plastic Surgery Institute in Vysoké nad Jizerou (ÚCHRaPCH) and the Motol University Hospital, Department of Orthopaedics (FNM) between 2018 and 2021 were evaluated. An analysis of demographic data, affected digits, and an assessment of functional outcomes using the Quick-DASH questionnaire were performed. The data were collected through Google Forms and then statistically analyzed. The subgroups were compared using the chi-square test and two-tailed unpaired t-test and logistic regression with Firth's correction was used to compare the obtained Quick-DASH scores.
Results:
A total of 124 trigger digits in 102 patients were evaluated, including 113 thumbs and 11 fingers; bilateral findings were observed in 20.6% of patients. The mean age at the time of surgery was 3.7 years. The questionnaire was completed by 57.8% of patients treated at ÚCHRaPCH and 57.9% at FNM. The median Quick-DASH score was 0.0, indicating no disability or hand function limitation. The average Quick-DASH score was 1.7. No significant differences were found between the centers in demographic parameters or achieved scores. The prevalence of a non-zero Quick-DASH score was 24%.
Discussion:
Our results, in line with global literature, confirm that surgical release of the A1 pulley is an effective method for treating pediatric trigger thumb or fingers with minimal complications. The online questionnaire survey proved beneficial for data collection. The limitation is the low response rate and the unavailability of suitable validated questionnaires for the given age group. The relatively high risk of a non-zero Quick-DASH score may be influenced by the inappropriate choice of questionnaire given the age of the subjects. An advantage of the data collection method used is the ability to require full completion of the questionnaire before submission, thereby eliminating the need to discard incomplete questionnaires.
Conclusions:
Surgical treatment of pediatric trigger digits provides excellent outcomes, and the use of online questionnaires is suitable for health data collection. Further research is needed to validate questionnaires for pediatric age categories and subsequently to expand the concept of web-based data collection.
