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Pediatric trigger thumb: clinical management update.

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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.