Acquired thumb flexion contracture in children: congenital trigger thumb

Area of Science:

• Pediatric Orthopedics
• Hand Surgery
• Developmental Pediatrics

Background:

• Trigger thumb is commonly described as a congenital condition in infants.
• The typical presentation involves a flexion contracture, often without the characteristic 'triggering' phenomenon.

Purpose of the Study:

• To determine the congenital incidence of trigger thumb in newborns.
• To evaluate the accuracy of the term "congenital trigger thumb".

Main Methods:

• Prospective examination of 4719 newborn infants.
• Review of 15 children aged 15-51 months who underwent surgery for the condition.

Main Results:

• No cases of trigger thumb were identified at birth in the prospective cohort.
• Surgically treated cases presented with flexion contracture, not evident at birth, and lacked triggering.
• The condition is acquired postnatally, with a fixed-flexion contracture being more common than triggering.

Conclusions:

• The term "congenital trigger thumb" is a misnomer.
• "Acquired thumb flexion contracture in children" is proposed as a more accurate description.
• Surgical division of the A-1 pulley is an effective treatment for persistent contractures after one year of age.