Trigger Thumb

Trigger thumb/ fingers is a condition in which thumb or finger of a child pops, clicks or catches when they try to straighten it. Thumb may lock in a bent position. If the thumb locks, child can pull it straight using their other hand. But child can’t straighten his own thumb/finger using his muscles of same finger. The tendon which is responsible for the movements of the fingers runs through palm within synovial sheath (A1 pulley).

Causes

Common age group of children having trigger thumbs between the ages of one to three. Likewise, they can have triggered thumb in one hand or both hands. Usually it doesn’t associate with trauma. However the parents must get the child’s trigger thumb examined and diagnosed by an experienced paediatric orthopaedic surgeon to identify the causes and symptoms precisely.

Symptoms

Trigger thumb is a clinical diagnosis, if the child’s thumb being locked in a bent position, and catching, clicking, or popping while moving the thumb. Some children with trigger thumb even experience pain and swelling in the thumbs. Hence, the symptoms of trigger thumb differ from one child to another.

Diagnosis

The skilled paediatric orthopaedician diagnose trigger thumb by examining the finger and observing common symptoms. While diagnosing trigger thumb, the paediatric orthopaedician examine the finger thoroughly to identify other medical problems like cerebral palsy, arthrogryposis etc.

Treatment

  1. Stretching exercises
  2. Massages
  3. Splinting
  4. Surgical release (Day care)

Initially paediatric orthopaedician treat trigger thumb through stretching, splitting, and message. They advise parents to make the child practice stretching exercise and perform message regularly. Based on the symptoms, they even make the child stretch and straighten the thumb by wearing a thumb splint. However, the orthopaedic perform specific day surgery to treat trigger thumb if the initial treatment fails. They treat trigger thumb surgically by performing trigger thumb release or A1 pulley release.

Results

The recovery time differs according to the trigger thumb treatment plan. If the orthopaedic decides to treat the condition non-surgically, the parents have to make the child perform stretch exercise and massage for a specific period of time. On the other hand, the trigger thumb release surgery will require the child to wear bandages for one to two weeks to protect the thumb. Child rarely need any other intervention after the procedure.

FAQs

Q: – Why it happened to my child?? What is the possible reason??

A: – Exact cause of this unknown (Idiopathic) but it happens because tendon get stuck in A1 pulley (tendon sheath) results in non smooth movements of tendon.

Q:  – Is this curable?? Will it need surgery?? How long surgery / Hospital stay / Recovery time??

A: – Yes, it’s curable by stretching exercises and massage and splinting.  Sometime needs surgery if failed in conservative treatment or severe cases. Surgery is a day care procedure with minimal hospital stay with good and smooth recovery.

Q: – Will this affect future growth of hand  and functional stamina of my baby??

A: – If treated timely and correctly, results are good without any functional deficit.

Q: – Ideal age for surgery??

A: – one to two years of age depend on severity and response of conservative treatment.

 

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