Open Versus Percutaneous Surgery for Trigger Thumb in Children

Ramírez-Barragán, A.; Martínez-Caballero, I.; Epeldegui-Torre, T.

doi:10.1016/S1988-8856(07)70005-6

Article information

Abstract

Bibliography

Download PDF

Statistics

Purpose

To compare open versus percutaneous surgery in the treatment of stenosing tenosynovitis of the thumb (trigger thumb) in a pediatric population.

Materials and methods

A retrospective study was performed comparing both surgical techniques by reviewing 108 patients (135 thumbs) with a follow-up period of 24 months.

Results

Six patients out of 92 (6.52%) were incapable of complete extension of the interphalangeal joint of the thumb after open surgery. When percutaneous surgery was performed there was recurrence in 15 thumbs of the 43 that underwent surgery (34.8%). No complications were seen related to lack of sensitivity, residual pain, nor alterations of thumb mobility in any of the patients in the two compared series.

Conclusions

Due to the percentage of recurrences seen, percutaneous surgery for trigger thumb is not recommended in a pediatric population.

Key words:

trigger thumb

open thumb surgery

percutaneous thumb surgery

children

Objetivo

Comparar la técnica quirúrgica abierta con la percutánea para el tratamiento de la tenosinovitis estenosante del pulgar en la infancia.

Material y método

Se realizó un estudio retrospectivo donde se revisaron 108 pacientes (135 pulgares) con un período de seguimiento medio de 24 meses, comparando ambas técnicas quirúrgicas.

Resultados

Seis pacientes de 92 (6,52%) presentaban incapacidad para la extensión completa de la articulación interfalángica del primer dedo tras cirugía abierta. Mediante cirugía percutánea la recidiva ocurrió en 15 pulgares de 43 intervenidos (34,8%). No aparecieron complicaciones relacionadas con déficit de sensibilidad, dolor residual, ni alteraciones de la movilidad del primer dedo en ninguna de las dos series comparadas.

Conclusiones

El porcentaje de recidiva acontecido tras el tratamiento percutáneo del pulgar en resorte justifica no recomendar su utilización en la población infantil.

Palabras clave:

pulgar en resorte

polectomía abierta

polectomía percutánea

niños

Full text is only aviable in PDF

References

[1.]

J.M. Dinham, D.F. Meggitt.

Trigger thumbs in children: a review of the natural history and indications for treatment in 105 patients.

J Bone Joint Surg Br, 56B (1974), pp. 153-155

[2.]

K.S. Eyres, M.I. McLaren.

Trigger thumb in children: results of surgical correction.

J R Coll Surg Edin, 36 (1991), pp. 197-198

[3.]

T.R. McAdams, M.S. Moneim, G.E. Omer.

Long-term follow-up of surgical release of the A1 Pulley in childhood trigger thumb.

J Pediatr Orthop, 22 (2002), pp. 41-43

Medline

[4.]

A.L. Dellon, F.C. Hansen.

Bilateral inability to grasp due to multiple congenital trigger fingers.

J Hand Surg Am, 5 (1980), pp. 470

Medline

[5.]

A.H.C. Tan, K.S. Lam, E.H. Lee.

The treatment outcome of trigger thumb in children.

J Pediatr Orthop, 11 (2002), pp. 256-259

[6.]

M. Herdem, H. Bayram, E. Togrul, Y. Sarpel.

Clinical analysis of the trigger thumb of childhood.

Turk J Pediatr, 45 (2003), pp. 237-239

Medline

[7.]

E.E. Sprecher.

Trigger thumb in infants.

J Bone Joint Surg Am, 31A (1949), pp. 672-674

Medline

[8.]

P.S. Mulpruek.

Spontaneous recovery of trigger thumbs in children.

J Hand Sur Br, 23B (1998), pp. 255-257

[9.]

A. Al-Harthy, G.M. Rayan.

Phalangeal osteochondroma: a cause of childhood trigger finger.

Br J Plast Surg, 56 (2003), pp. 161-163

Medline

[10.]

J. Chia, R.W. Pho, R. Sinniah.

«Congenital» trigger thumb caused by intratendinous granulation tissue.

J Hand Surg Br, 21B (1996), pp. 612-613

[11.]

R.A. Dunsmuir, D.A. Sherlock.

The outcome of treatment of trigger thumb in children.

J Bone Joint Surg Br, 82B (2000), pp. 736-738

[12.]

J.B. Slakey, W.L. Hennrikus.

Acquired thumb flexion contracture in children: congenital trigger thumb.

J Bone Joint Surg Br, 78B (1996), pp. 481-483

[13.]

J. Lorthioir.

Surgical treatment of trigger finger by a subcutaneous method.

J Bone Joint Surg Am, 40A (1959), pp. 793-795

[14.]

K.I. Ha, M.J. Park, C.W. Ha.

Percutaneous release of trigger digits: a tecnique and results using a specially desing knife.

J Bone Joint Surg Br, 83B (2001), pp. 75-77

[15.]

G.A. Turowski, P.D. Zdakiewicz, J.G. Thomson.

The results of surgical treatment of trigger finger.

J Hand Surg Am, 22A (1997), pp. 145-149

[16.]

D.M. Eastwood, K.J. Gupta, D.P. Johnson.

Percutaneous release of the trigger finger: an office procedure.

J Hand Surg (Am), 17A (1992), pp. 114-117

[17.]

E.C.A. Gilberts, J.C.J. Wereldsma.

Long-term results of percutaneous and open surgery for trigger fingers and thumbs.

Int Surg, 87 (2002), pp. 48-52

Medline

[18.]

D.F. Pope, S.W. Wolfe.

Safety and efficacy of percutaneous trigger finger release.

J Hand Surg Am, 20A (1995), pp. 280-283

[19.]

B. Cihantimur, S. Akin, M. Ozcan.

Percutaneous treatment of trigger finger: 34 fingers followed 0,5-2 years.

Acta Orthop Scand, 69 (1998), pp. 167-168

Medline

[20.]

M.R. Patel, V.J. Moradia.

Percutaneous release of trigger digit with and without cortisone inyection.

J Hand Surg Am, 22A (1997), pp. 150-155

[21.]

H.C. Wang, G.T. Lin.

Retrospective study of open versus percutaneous surgery for trigger thumb in children.

Plast Reconstr Surg, 115 (2005), pp. 1963-1970

Medline

[22.]

E. Ger, P. Kupcha, D. Ger.

The management of trigger thumb in children.

J Hang Surg Am, 16A (1991), pp. 944-947

[23.]

J.R. Doyle, W.F. Blythe.

Anatomy of the flexor tendon sheath and pulleys of the thumb.

J Hang Surg Am, 2A (1977), pp. 149-151

Indexed in:

Follow us:

Indexed in:

Follow us:

Subscribe to our newsletter