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thumb
Christian Dumontier MD, PhD
Centre de la Main, Guadeloupe, FWI
Pediatric not congenital
Slakey JB, Hennrikus WL. Acquired thumb flexion contracture in children. J Bone Joint Surg 1996;78B:481–483.
Kikuchi N, Ogino T. Incidence and development of trigger thumb in children. J Hand Surg 2006;31A:541–543. Rodgers
WB, Waters PM. Incidence of trigger digits in newborns. J Hand Surg 1994;19A:364–368.
Pediatric trigger thumb
• Prevalence at 1 year is approximately
3,3 per 1,000 live birth.
Dinham JM, Meggitt BF. Trigger thumbs in children. J Bone Joint Surg 1974;56B:153–155.
Baek GH, Kim JH, Chung MS, Kang SB, Lee YH, Gong HS. The natural history of pediatric trigger thumb. J Bone
Joint Surg 2008; 90A:980 –985.
Natural history
Tan AH, Lam KS, Lee EH. The treatment outcome of trigger thumb in children. J Pediatr Orthop B 2002;11:256–259.
Dunsmuir RA, Sherlock DA. The outcome of treatment of trigger thumb in children. J Bone Joint Surg 2000;82B:736–
738.
Watanbe H, Hamada Y, Toshima T, Nagasawa K. Conservative treatment for trigger thumb in children. Arch Orthop
Trauma Surg 2001;121:388 –390.
Non-operative treatment: splinting
• Nighttime IP joint extension splinting in 40 trigger thumbs for
an average of 10 months.
• A1 pulley release
McAdams TR, Moneim MS, Omer GE Jr. Long-term follow-up of surgical release of the A(1) pulley in childhood trigger
thumb. J Pediatr Orthop 2002;22:41–43.
When to perform surgery ?
• Children who had surgery after the age of 3 years took
longer (many months) to correct the contracture - Ger.
Ger E, Kupcha P, Ger D. The management of trigger thumb in children. J Hand Surg 1991;16A:944–947.
Dinham JM, Meggitt BF. Trigger thumbs in children. A review of the natural history and indications for treatment in 105
patients. J Bone Joint Surg 1974;56B:153–155.
McAdams TR, Moneim MS, Omer GE Jr. Long-term follow-up of surgical release of the A(1) pulley in childhood trigger
thumb. J Pediatr Orthop 2002;22:41–43.
Outcomes of surgical release
• Overall, favorable results may be expected after surgical release.
Marek DJ et al.Surgical Release of the Pediatric Trigger Thumb. J Hand Surg 2011;36A:647–652
Questionnaire
• For treatment of a 2-year-old with a 6-month
history of a locked trigger thumb,
Marek DJ et al.Surgical Release of the Pediatric Trigger Thumb. J Hand Surg 2011;36A:647–652
Conclusion