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Trigger Thumb

January 29, 2024

Pedsortho.com Staff

Topics - Congenital

Nature, Causes, and Treatment of Trigger Thumb in Children

Trigger thumb in children, also known as pediatric trigger thumb or stenosing tenosynovitis, is a condition where the thumb gets stuck in a bent position, as if squeezing a trigger. It typically affects children under the age of 6 and can be present at birth or develop in early childhood. Here are key aspects of this condition:

Characteristics

  • Fixed Bent Thumb: The thumb may be locked in a bent position or have a noticeable click when extended.

  • Painless Condition: Initially, trigger thumb is usually painless.

  • Difficulty in Straightening Thumb: The child may struggle to extend the thumb fully.

Causes

  • Nodule Formation: The condition is often due to the development of a nodule on the tendon that controls thumb movement.

  • Tendon Sheath Inflammation: The sheath surrounding the tendon becomes too narrow, restricting the tendon's movement.

Risk Factors

  • Age and Gender: More common in children under 6, with no significant gender difference.

  • Congenital Factors: Some children are born with a predisposition to the condition.

Diagnosis

  • Physical Examination: A doctor can diagnose trigger thumb by examining the thumb and observing its movement.

  • Medical History: Taking note of any relevant family history or developmental milestones.

Treatment

  • Observation and Monitoring: In some cases, especially in very young children, the condition can resolve on its own.

  • Stretching Exercises: Gentle stretching of the thumb may be recommended.

  • Splinting: Immobilizing the thumb can sometimes help in correcting the condition.

  • Surgery: In persistent or severe cases, a simple surgical procedure to release the tendon may be necessary.

Prognosis

  • Spontaneous Resolution: Many cases of trigger thumb in young children resolve without treatment.

  • Excellent Outcomes with Surgery: When surgery is needed, it is generally very successful with minimal complications.

Long-Term Outlook

  • Normal Function: Most children regain normal thumb movement after treatment.

  • Rare Recurrence: Recurrence of trigger thumb after treatment is uncommon.

It's important to consult a healthcare professional for an accurate diagnosis and appropriate management, especially if the condition persists or affects the child's hand function. Regular follow-up is important to ensure proper healing and recovery.

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