title: Percutaneous trigger thumb release in children.
abstract: The objective of this study was to determine whether percutaneous release of the A1 pulley is an adequate treatment of trigger thumb in children. Twenty-three children under the age of 6 years with 27 trigger thumbs fixed in flexion were evaluated prospectively. All were treated with a percutaneous release of the A1 pulley in an ambulatory setting and followed for at least 1 year. Interphalangeal and metacarpophalangeal joint range of motion, pinch strength, static two-point discrimination sensibility, and triggering were examined and compared with the unaffected thumb at the end of follow-up. After a mean follow-up of 3 years, 25 of the thumbs had an excellent result without residual triggering. Two of these thumbs had mild metacarpophalangeal extension deficit 1 month after surgery that resolved completely with specific exercises. One thumb relapsed and required subsequent open release and was considered a poor result. One child was lost to follow-up. There were no sensibility defects, strength loss, interphalangeal motion loss, or metacarpophalangeal hyperextension deformities. Percutaneous release of the A1 pulley is an effective and safe option in the treatment of trigger thumb in children.
authors.affiliation: Departamento de Cirugía Ortopédica y Traumatología, Hospital Ramón y Cajal, Madrid, Spain. drmri@hotmail.com
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Ruiz-Iban
authors.forename: Pedro
authors.initials: P
authors.lastname: Gonzalez-Herranz
authors.forename: Jose A Lopez
authors.initials: JA
authors.lastname: Mondejar
mesh_terms: D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003286:Contracture / Q000601:surgery*; D005260:Female; D005384:Finger Joint / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D019637:Orthopedic Procedures / Q000379:methods*; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D018570:Risk Assessment; D013710:Tendons / Q000503:physiopathology / Q000601:surgery*; D013933:Thumb / Q000002:abnormalities*; D013997:Time Factors; D016896:Treatment Outcome