Developmental Trigger Thumb.

Abstract:

:Developmental trigger thumb, although uncommon, can be easily identifiable in the pediatric outpatient visit. Patients often present with their thumb locked in flexion and a firm nodule at the base of the thumb. The thumb is usually passively correctable and nonpainful. It is important to examine the opposite thumb as bilateral trigger thumbs occur at a rate of 25% to 30%. Nonsurgical options have been proposed in the past including watchful waiting, extension exercises, splinting, and steroid injections with mixed results. Surgical intervention is indicated when there is painful triggering or the thumb is not passively correctable. Surgical treatment is an outpatient procedure that involves releasing the thumb flexor tendon from a small fibrous sheath called the A1 pulley. The overall recurrence rate after surgery is 1.4%. Our recommendation is for early referral to a pediatric orthopedic surgeon to evaluate for the need for surgical intervention.

journal_name

Pediatr Ann

journal_title

Pediatric annals

authors

Twu J,Angeles J

doi

10.3928/00904481-20160317-02

subject

Has Abstract

pub_date

2016-04-01 00:00:00

pages

e135-8

issue

4

eissn

0090-4481

issn

1938-2359

journal_volume

45

pub_type

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