XML Print

Department of Plastic and Reconstructive Surgery, Iran University of Medical Sciences, Tehran, Iran.
Abstract:   (87 Views)
Although trigger finger is common, pediatric trigger thumb is uncommon. In the trigger thumb the finger is held in flexed position and in examination a nodule in the palmar aspect of trigger finger is palpated  called Notta node. The etiology of trigger finger is unknown and can occur isolated without relation to any syndrome, however there are some evidences that suggest genetic etiology. We reported 2.5 yr old twin toddlers who both had bilateral trigger thumb. Grandfather of the twins had the disease.
Pediatric trigger thumb is uncommon. Although trigger thumb and finger have the same presentation, they can involve different anatomical structures. Notta nodule is palpable in both. Bent or straightening of thumb or finger would produce painful popping and clicking and the affected finger or thumb can get stuck in bent and extended position. Based on physical examination and symptoms trigger finger are classified in to four stages and each has its own treatment. There are evidences that support congenital hypothesis in pediatric trigger thumb such as bilateral presentation in identical twins, first degree familiar association and etc. Before the 1st year of life, 30% of trigger thumb will get resolved and it is better to postpone the surgery until 2 yr of age .A1 pulley release has a good result in pediatric trigger thumb treatment. Trigger thumb is a multifactorial disease without clear pattern but involvement of twins, siblings and family members suggest the effect of genetic and hereditary in this problem but further researches are needed to prove this theory.
Full-Text [PDF 513 kb]   (37 Downloads)    
Type of Study: Original Article | Subject: Special
Received: 2021/06/8 | Accepted: 2021/02/22

1. 1 Flatt, Adrian E. "Notta's nodules and trigger digits." Proceedings (Baylor University. Medical Center) vol. 20,2 (2007): 143-5. [DOI:10.1080/08998280.2007.11928272]
2. 2 Kakel R, Van Heerden P, Gallagher B, Verniquet A. Pediatric trigger thumb in identical twins: congenital or acquired? Orthopedics. 2010 Mar;33(3) [DOI:10.3928/01477447-20100129-33]
3. 3 Cardon LJ, Ezaki M, Carter PR. Trigger finger in children. J Hand Surg Am. 1999 Nov;24(6):1156-61. [DOI:10.1053/jhsu.1999.1156]
4. 4 Waters PM. Trigger thumb Lovell and winters pediatric orthopedics 6th ed. Lippincott-Raven Philadelphia; 2008.
5. 5 Marek DJ, Fitoussi F, Bohn DC, Van Heest AE. Surgical release of the pediatric trigger thumb. J Hand Surg Am. 2011 Apr;36(4):647-652.e2. [DOI:10.1016/j.jhsa.2011.01.011]
6. 6 Wang ED, Xu X, Dagum AB. Mirror-image trigger thumb in dichorionic identical twins. Orthopedics. 2012 Jun;35(6):e981-3. [DOI:10.3928/01477447-20120525-48]
7. 7 Buchman MT, Gibson TW, McCallum D, Cuda DD, Ramos AG Jr. Transmission electron microscopic pathoanatomy of congenital trigger thumb. Journal of Pediatric Orthopedics. 1999 May-Jun;19(3):411-412. DOI: 10.1097/00004694-199905000-00024. [DOI:10.1097/00004694-199905000-00024]

Add your comments about this article : Your username or Email:

© 2021 CC BY-NC 4.0 | World Journal of Plastic Surgery

Designed & Developed by : Yektaweb