title: The "Trigger" Thumb Locked in Extension - An Unusual Presentation of a Common Paediatric Condition.
abstract: We report a variant of paediatric trigger thumb which is locked in extension rather than flexion.
  
  
  
  Eleven children with 14 trigger thumbs (three bilateral) locked in extension were reviewed retrospectively over a 12-year period. The number of flexed trigger thumbs encountered over this period was established from the operating room database.
  
  
  
  All children were treated with release of the A1 pulley. Nine children achieved a full range of motion at the interphalangeal joint. One child with bilateral extended trigger thumbs required bilateral dorsal capsulotomy and another child developed temporary mild triggering in flexion.
  
  
  
  Approximately 1% of trigger thumbs treated operatively at this institution presented as the extended variant. Trigger thumb locked in extension should be considered in a child presenting with inability to flex the thumb.
authors.affiliation: 1 Department of Plastic Surgery and Maxillofacial Surgery, Royal Children's Hospital, Melbourne, Australia.
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Johnstone
authors.affiliation: 1 Department of Plastic Surgery and Maxillofacial Surgery, Royal Children's Hospital, Melbourne, Australia.
authors.forename: L J
authors.initials: LJ
authors.lastname: Currie
authors.affiliation: 1 Department of Plastic Surgery and Maxillofacial Surgery, Royal Children's Hospital, Melbourne, Australia.
authors.forename: Edmund W
authors.initials: EW
authors.lastname: Ek
authors.affiliation: 1 Department of Plastic Surgery and Maxillofacial Surgery, Royal Children's Hospital, Melbourne, Australia.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Wilks
authors.affiliation: 1 Department of Plastic Surgery and Maxillofacial Surgery, Royal Children's Hospital, Melbourne, Australia.
authors.forename: David B
authors.initials: DB
authors.lastname: McCombe
authors.affiliation: 1 Department of Plastic Surgery and Maxillofacial Surgery, Royal Children's Hospital, Melbourne, Australia.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Coombs
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D013933:Thumb / Q000503:physiopathology / Q000601:surgery*; D052582:Trigger Finger Disorder / Q000503:physiopathology / Q000601:surgery*
keywords: Extended; Stenosing tenosynovitis; Trigger thumb