Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep 4;5(9):736-741.
doi: 10.1302/2633-1462.59.BJO-2024-0056.R1.

Paediatric trigger thumbs: patient-reported outcome measures over a minimum of ten years' follow-up

Sebastian Farr  1 , Teofil Mataric  2 , Bettina Kroyer  3 , Sitanshu Barik  4
Affiliations

Paediatric trigger thumbs: patient-reported outcome measures over a minimum of ten years' follow-up

Sebastian Farr et al. Bone Jt Open. .

Abstract

Aims: The paediatric trigger thumb is a distinct clinical entity with unique anatomical abnormalities. The aim of this study was to present the long-term outcomes of A1 pulley release in idiopathic paediatric trigger thumbs based on established patient-reported outcome measures.

Methods: This study was a cross-sectional, questionnaire-based study conducted at a tertiary care orthopaedic centre. All cases of idiopathic paediatric trigger thumbs which underwent A1 pulley release between 2004 and 2011 and had a minimum follow-up period of ten years were included in the study. The abbreviated version of the Disabilities of Arm, Shoulder and Hand questionnaire (QuickDASH) was administered as an online survey, and ipsi- and contralateral thumb motion was assessed.

Results: A total of 67 patients completed the survey, of whom 63 (94%) had full interphalangeal joint extension or hyperextension. Severe metacarpophalangeal joint hyperextension (> 40°) was documented in 15 cases (22%). The median QuickDASH score was 0 (0 to 61), indicating excellent function at a median follow-up of 15 years (10 to 19). Overall satisfaction was high, with 56 patients (84%) reporting the maximal satisfaction score of 5. Among 37 patients who underwent surgery at age ≤ two years, 34 (92%) reported the largest satisfaction, whereas this was the case for 22 of 30 patients (73%) with surgery at aged > two years (p = 0.053). Notta's nodule resolved in 49 patients (73%) at final follow-up. No residual triggering or revision surgery was observed.

Conclusion: Surgical release of A1 pulley in paediatric trigger thumb is an acceptable procedure with excellent functional long-term outcomes. There was a trend towards higher satisfaction with earlier surgery among the patients.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts interest to disclose.

Figures

Fig. 1
Fig. 1
Barplot is showing differences of satisfaction level (5 vs < 5) depending on the magnitude of interphalangeal joint extension. a) Lack of extension of 40° and more; b) lack of 20°; c) full extension to 0°; d) > 0°/hyperextension.
See this image and copyright information in PMC

References

    1. Shah AS, Bae DS. Management of pediatric trigger thumb and trigger finger. J Am Acad Orthop Surg. 2012;20(4):206–213. doi: 10.5435/JAAOS-20-04-206. - DOI - PubMed
    1. Cardon LJ, Ezaki M, Carter PR. Trigger finger in children. J Hand Surg Am. 1999;24(6):1156–1161. doi: 10.1053/jhsu.1999.1156. - DOI - PubMed
    1. Tordai P, Engkvist O. Trigger fingers in children. J Hand Surg Am. 1999;24(6):1162–1165. doi: 10.1053/jhsu.1999.1162. - DOI - PubMed
    1. Farr S, Grill F, Ganger R, Girsch W. Open surgery versus nonoperative treatments for paediatric trigger thumb: a systematic review. J Hand Surg Eur Vol. 2014;39(7):719–726. doi: 10.1177/1753193414523245. - DOI - PubMed
    1. Farr S, Taurok D. Splinting for the treatment of pediatric trigger thumbs: a pilot study. Wien Med Wochenschr. 2022;172(13–14):294–295. doi: 10.1007/s10354-021-00860-8. - DOI - PubMed