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Pediatric trigger thumb treated with A1 pulley release with or without postoperative thumb immobilization: a
Biao Wang1, Chunxu Zhang2, Zhenwei Li1
1Department of Orthopaedics, Henan Children's Hospital, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Children's Hospital, 33 Longhu Waihuan East Road, Henan, Zhengzhou, 450018, China.
Background:
This study aimed to compare clinical outcomes in patients with trigger thumb who underwent A1 pulley release, with or without postoperative thumb immobilization.
Methods:
We retrospectively analyzed 207 patients with trigger thumb, comprising 97 in the splinted group and 110 in the non-splinted group, who underwent surgical treatment at our center. Recurrence rates, differences in extension angles between affected and unaffected interphalangeal (IP) joints, and postoperative complications were compared between the two groups.
Results:
According to Baek's criteria, all patients except three experienced complete resolution of their symptoms. At the final follow-up, one case of IP joint flexion contracture was observed in the splinted group and two in the non-splinted group, with all cases showing flexion contractures of less than 10°. No recurrences were noted in either group. One case of tendon bowstringing was noted in the splinted group, while two cases were seen in the non-splinted group. The mean difference in extension angles between the affected and unaffected IP joints at the last follow-up was 0.96 ± 1.86° (range: 0-13°) in the splinted group and 1.08 ± 2.06° (range: 0-12°) in the non-splinted group (P > 0.05).
Conclusions:
Our results suggest that postoperative thumb immobilization following A1 pulley release may not be necessary for patients with trigger thumb, as it does not significantly impact functional outcomes or recurrence rates.
