Release of Trigger Finger in Children: Long Term Results

Abstract

During a 10 year period 58 patients had 80 trigger fingers operated on at this hospital. The male/female ratio was 32:26 and most children were operated on at between the ages of 2 and 4 years, and 15 months (range 2-99) after the lesion had been noticed. The operation was quick and effective with no complications. Only one patient was re-operated on, with a good result. Thirteen patients had bilateral lesions. Both hands were examined and in 11 patients (19%) we found that the thickening corresponding to the trigger finger was also present on the opposite side but giving no symptoms. There seems to be a predisposition to bilateral affections.

Retrospective Study of Open versus Percutaneous Surgery for Trigger Thumb in Children

“…These results are compatible with recent studies. 9,11,13,19 However, the distribution of the age of onset of trigger thumb shows 20.8 percent at less than 6 months in our study. Our data seem not to agree with current studies 8,9 regarding "acquired origin."…”

Surgical Treatment of the Pediatric Trigger Finger

“…9,10,[12][13][14] Whereas constriction at the A1 pulley is more commonly the cause of triggering in adults, it has been noted that nodular thickening or fusiform swelling of the flexor tendon is more frequently found in pediatric trigger fingers. 6,7,9,13,15 Calcifications or granulations within the tendon have also been described less commonly. 16,17 Furthermore, anatomic aberrations of the FDS terminal slips and flexor tendon chiasm may also contribute to mechanical triggering.…”

“…1 Historically, information regarding this uncommon condition has come in the form of case reports and case series combining both trigger thumbs and fingers. [1][2][3][4][5][6][7][8][9][10][11] Recent reports by Cardon et al and Tordai and Engkvist have described a variety of surgical approaches in efforts to achieve better outcomes, including widening of the flexor digitorum superficialis (FDS) decussation, A1 and partial A2 pulley division, and partial or complete resection of the FDS tendon. 1,2 Abnormal anatomic relationships between the FDS and flexor digitorum profundus (FDP) tendons have been postulated to cause triggering of digits in the pediatric population.…”

Percutaneous Trigger Thumb Release in Children

“…Trigger digit is an uncommon problem in children that is related to the adult form but distinctly different in the digit affected (the thumb is most frequently affected 11,12 ), the clinical findings (usually children present with a IP joint locked in flexion 13 ), and the nature of the pathologic findings (in children it is common to identify an engrossment of the tendon, the Notta nodule 14 ). The classic treatment consists of open A1 pulley release, 13 but the indications for surgical treatment are a source of discussion, as there is evidence that a more conservative approach with splinting and surgical delay until older age can be adequate.…”