Pediatric trigger thumb: clinical management update

Area of Science:

• Pediatric Orthopedics
• Hand Surgery
• Developmental Pediatrics

Background:

• Pediatric trigger thumb is a prevalent condition, affecting 1 in 2000 children.
• Misdiagnosis as fracture or dislocation is common, emphasizing the need for accurate identification.
• Treatment strategies, including nonoperative and surgical options, are debated.

Purpose of the Study:

• To review current literature on pediatric trigger thumb.
• To discuss diagnostic criteria and management options.
• To highlight recent findings and their implications for clinical practice.

Main Methods:

• Review of recent literature on pediatric trigger thumb.
• Analysis of diagnostic findings such as volar nodule and interphalangeal joint flexion.
• Evaluation of outcomes for both conservative and surgical treatments.

Main Results:

• Spontaneous resolution occurs in 30-50% of cases over several years, especially with interphalangeal angles <30°.
• Surgical A1 pulley release is definitive with excellent outcomes and low complications, particularly for children >2 years or with severe cases.
• Certain congenital malformations are more frequent in children with trigger thumbs.

Conclusions:

• Pediatric trigger thumb is common, with frequent spontaneous resolution.
• Accurate diagnosis involves identifying a volar nodule and thumb interphalangeal joint flexion.
• Observation is acceptable for mild cases, while surgery is highly effective for persistent or severe cases. Management should be individualized.