title: Surgical release of the pediatric trigger thumb.
abstract: OBJECTIVE
  The spontaneous recovery rate for locked pediatric trigger thumb (PTT) has recently been reported at between 24% and 66%; these studies concluded that a conservative approach for this condition could be adopted. The aims of this study were to review our results of surgical release of the PTT and to survey pediatric hand surgeons regarding their practice patterns for treatment of the PTT.
  
  
  METHODS
  After institutional review board approval, we retrospectively reviewed 173 consecutive patients with 217 thumbs treated surgically at our institution. An e-mail survey of 27 pediatric hand surgeons questioned treatment of a 2-year-old child with a 6-month history of a locked trigger thumb and of an intermittently triggering thumb.
  
  
  RESULTS
  The retrospective review demonstrated that preoperative range of motion averaged 36° loss of extension (range, 0° to 90°; SD, 22°); postoperative range of motion averaged 1° loss of extension (range, 0° to 30°; SD, 7°) at 27-day follow-up. Using a parent questionnaire at an average follow-up of 4.2 years, there were no major complications or recurrences identified. Five thumbs developed minor skin complications that healed with conservative management. There were no secondary surgeries. The practice pattern survey demonstrated that 85% of pediatric hand surgeons would treat a locked PTT in a 2-year-old with surgical release and 52% would treat an intermittently triggering thumb in a 2-year-old with continued observation if the triggering thumb was not painful.
  
  
  CONCLUSIONS
  The surgical results reported in this study, along with the practice pattern survey, confirm that surgical release is a short, safe, and effective procedure when performed by specialty trained hand surgeons, and it is the treatment of choice for a locked PTT.
authors.affiliation: Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN 55454, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Marek
authors.forename: Franck
authors.initials: F
authors.lastname: Fitoussi
authors.forename: Deborah C
authors.initials: DC
authors.lastname: Bohn
authors.forename: Ann E
authors.initials: AE
authors.lastname: Van Heest
mesh_terms: D000367:Age Factors; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D011182:Postoperative Care / Q000379:methods; D010818:Practice Patterns, Physicians'; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D017751:Safety Management; D013997:Time Factors; D016896:Treatment Outcome; D052582:Trigger Finger Disorder / Q000175:diagnosis / Q000534:rehabilitation / Q000601:surgery*