Clin Orthop Surg.  2011 Jun;3(2):157-159. 10.4055/cios.2011.3.2.157.

The Natural History of Pediatric Trigger Thumb: A Study with a Minimum of Five Years Follow-up

• Baek GH
• Lee HJ

• KMID: 1719314
• DOI: http://doi.org/10.4055/cios.2011.3.2.157

Abstract

BACKGROUND
Pediatric trigger thumb is due to deformed flexion of the interphalangeal joint. We previously reported that pediatric trigger thumb can spontaneously resolve in > 60% of patients at the median follow-up of 48 months. The purpose of this study was to determine whether there were any more cases of resolution with a follow-up of more than 5 years and whether any residual deformities remain, and so to confirm the natural history of pediatric trigger thumb.
METHODS
We prospectively followed 87 thumbs in 67 patients with pediatric trigger thumb and these patients didn't receive any treatment such as passive stretching, splinting or surgery. The date of the first visit ranged from April 1994 to March 2005. The patients were evaluated every six-months prior to resolution and annually after resolution. The median duration of follow-up was 87.3 months (range, 60 to 156 months).
RESULTS
Of the 87 trigger thumbs, 66 (75.9%) resolved spontaneously. The median time from the initial visit to resolution was 49.0 months (95% confidence interval, 41.1 to 56.9). There were no residual deformities that resolved beyond 48 months. Although complete resolution did not occur in the remaining 21 thumbs, the flexion deformities did improve in all 21 thumbs. There were no other differences between the two groups besides the average duration of follow-up. There was no difference in resolution based on gender.
CONCLUSIONS
Pediatric trigger thumb can spontaneously resolve in > 75% of the cases after a follow-up period of at least 5 years. An operation may be delayed or avoided in the majority of cases. This may help both the families and the surgeons make decisions regarding the proper treatment of pediatric trigger thumb.

Keyword

Pediatric trigger thumb; Natural history; Conservative management

MeSH Terms

Adolescent
Child
Child, Preschool
Female
Follow-Up Studies
Humans
Infant
Kaplan-Meier Estimate
Male
*Remission, Spontaneous
Statistics, Nonparametric
Time Factors
Trigger Finger Disorder/*physiopathology

Figure

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  Fig. 1 The Kaplan-Meier survival curve with resolution of the patients' trigger thumbs as the end point. The median survival time (the median time of having trigger thumb) from the initial visit to the time of resolution was 49 months (95% confidence interval, 41.1 to 56.9).

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