Trigger thumb in children: results of surgical treatment in children above 5 years of age.
BACKGROUND
There have been debates about the results of surgical treatment in older children, even though many studies showed excellent results in pediatric trigger thumb. The objective of this study was to identify the possible problems or complications related to the delayed surgery for trigger thumb in children. Authors clinically reexamined the patients who had undergone A1 pulley release above the age of 5 years and analyzed the results of surgical treatment.


METHODS
A retrospective study of 31 trigger thumbs was performed on 23 consecutive children treated using a standardized surgical technique. The mean age at the operation was 7.46 years and average period of clinical follow-up was 2 years and 3 months. We investigated the presence or absence of interphalangeal joint flexion contracture, triggering, recovery of active range of motion, postoperative period that the patients get more than 0 degree interphalangeal joint extension, and complications.


RESULTS
Flexion contracture and painful triggering were successfully relieved after surgery in all cases. Patients showed variable periods in improving temporary extension weakness of interphalangeal joint, but there was no statistical difference in the final result between early and delayed improvement or between symptom duration and healing time. None of these patients had any postoperative complications.


CONCLUSIONS
Surgical treatment with A1 pulley release for over 5 years of age resulted in successful resolution of trigger thumb and satisfactory clinical outcome in all our cases regardless the age at the time of surgery. From the author's findings, we can expect satisfactory results of surgical treatment in pediatric trigger thumb even in the case of delayed diagnosis or late treatment.
Han
Soo Hong
SH
Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea. hsoohong@hanmail.net
Yoon
Hyung Ku
HK
Shin
Dong Eun
DE
Song
Dae Guen
DG
D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D057210:Delayed Diagnosis; D005260:Female; D005384:Finger Joint / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures; D010146:Pain / Q000209:etiology; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D052582:Trigger Finger Disorder / Q000601:surgery*