Percutaneous release for trigger thumbs in children: improvements of the technique and results of 31 thumbs

Abstract

Purpose: Trigger thumb is a relatively uncommon condition in children. If it occurs or persists after 1 year of age, surgical release is the most traditional treatment method. The aim of this prospective study is to describe a technique for the percutaneous release of trigger thumb and to assess the clinical outcome of the presented technique in the pediatric age group.

Methods: This study includes 31 thumbs of 26 consecutive children with a mean age of 2.6 years. An 18-gauge needle that was connected to 10-cc saline filled syringe was used as the surgical instrument for release. Contrary to the earlier reports, the A1pulley was cut from distal pole of the Notta nodule towards the proximal direction.

Results: Mean follow-up period was 2.5 years. A successful release without any complication was obtained in all (97% of thumbs) but 1 thumb. Recurrence was seen in only 1 thumb at postoperative 3 weeks.

Conclusion: The presented minimal invasive surgical procedure has a high rate of satisfactory outcome, a minimal rate of complications, and a high rate of parent satisfaction. As percutaneous release has satisfactory and encouraging results, it can be a preferred method by the parents for trigger thumb release. STUDY LEVEL: III.