Liječnički vjesnik, Vol. 141 No. 3-4, 2019.
Review article
https://doi.org/10.26800/LV-141-3-4-13
Trigger thumb in children
Lucija Pavljak
; Klinika za kirurgiju Medicinskog fakulteta Sveučilišta u Zagrebu, KBC Zagreb
Krešimir Bulić
; Klinika za kirurgiju Medicinskog fakulteta Sveučilišta u Zagrebu, KBC Zagreb
Anko Antabak
; Klinika za kirurgiju Medicinskog fakulteta Sveučilišta u Zagrebu, KBC Zagreb
Abstract
The natural course of the condition in pediatric trigger thumb is still controversial, and accordingly, the recommendations for treatment vary considerably and there are no clear and broadly accepted guidelines. In
this paper, we tried to provide a current literary overview of the disease progression and diagnostic and therapeutic abilities with an emphasis on the ultimate outcome of the treatment. Trigger thumb represents one of the most common pediatric hand conditions, mostly seen in preschool children. As a result of anatomic size mismatch between the flexor pollicis longus tendon and its sheath, disrupted tendon gliding is characteristic. The interphalangeal joint of the affected thumb fixed in a flexion contracture presents typical clinical finding. The first description of trigger thumb is attributed to Notta, and the palpable nodule at the volar aspect of the interphalangeal joint flexion crease still bears his name. Medical history and physical examination are used to diagnose this deformity with ultrasound as a potential early diagnostic tool. It is possible to misdiagnose a fracture, dislocation of the thumb or thumb-in-palm deformity. Clinical investigation has improved our understanding of the natural history and its benignancy. Therapeutic treatment depends on parent and physician preference. It can be either conservative, consisting of splint therapy and passive stretching exercises, or surgical, releasing of the A1 pulley that reliably
restores thumb interphalangeal joint motion. Although it may take several years for spontaneous resolution, families willing to wait are given an opportunity to avoid hospitalization stress and surgical intervention.
Keywords
TRIGGER FINGER DISORDERS – diagnosis, etiology, therapy; THUMB; FINGER JOINT; RANGE OF MOTION, ARTICULAR; TREATMENT OUTCOME; CHILD
Hrčak ID:
220211
URI
Publication date:
27.5.2019.
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