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The natural history of pediatric trigger thumb

Cited 29 time in Web of Science Cited 39 time in Scopus
Authors
Baek, Goo Hyun; Kim, Ji Hyeung; Chung, Moon Sang; Kang, Seung Baik; Lee, Young Ho; Gong, Hyun Sik
Issue Date
2008-05-03
Publisher
Journal of Bone and Joint Surgery, Inc.
Citation
J Bone Joint Surg [Am] 2008;90(5):980-5
Keywords
ChildChild, PreschoolFemaleHumansInfantKaplan-Meiers EstimateMaleProspective StudiesRemission, SpontaneousTrigger Finger Disorder/*rehabilitation
Abstract
BACKGROUND: Pediatric trigger thumb is a condition of flexion deformity of the interphalangeal joint in children. Although the surgical outcome is satisfactory, the indications for nonoperative treatment for this condition are not clear. The aim of the present study was to determine the rate of resolution of untreated pediatric trigger thumb. METHODS: Data on seventy-one thumbs in fifty-three children were collected prospectively. The dates of the first visits ranged from April 1994 to March 2004. Patients were diagnosed with pediatric trigger thumb during initial outpatient department visits. During the present study, no treatment such as passive stretching or splinting was applied. The amount of flexion deformity at the thumb interphalangeal joint was measured at every six-month follow-up visit, and the duration of follow-up was at least two years after diagnosis. The end point of follow-up was when the deformity caused pain or secondary deformity or prevented normal use of the hand. The median duration of follow-up was forty-eight months. RESULTS: Of the seventy-one trigger thumbs, forty-five (63%) resolved spontaneously. The median time from the initial visit to resolution was forty-eight months. There was no significant difference in the pattern of resolution between patients with unilateral and bilateral trigger thumb. Although resolution was not observed in the remaining twenty-six thumbs, flexion deformities improved in twenty-two thumbs. For the first two years after the initial visit, the mean flexion deformity significantly decreased over the one-year intervals (p < 0.05). CONCLUSIONS: Pediatric trigger thumb can be expected to resolve without treatment in >60% of patients. Moreover, the flexion deformity can be expected to show an improving pattern in patients who do not have resolution. This information may help both parents and surgeons to make decisions regarding the treatment of pediatric trigger thumb.
ISSN
1535-1386 (Electronic)
Language
English
URI
http://www.ejbjs.org/cgi/reprint/90/5/980.pdf

http://hdl.handle.net/10371/67449
DOI
https://doi.org/10.2106/JBJS.G.00296
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College of Medicine/School of Medicine (의과대학/대학원)Orthopedic Surgery (정형외과학전공)Journal Papers (저널논문_정형외과학전공)
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