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 Vol. 20 No. 2, August 2008
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AAP Grand Rounds 20:22-23 (2008)
© 2008 American Academy of Pediatrics

ORTHOPAEDICS

A Child’s Trigger Thumb May Not Require Surgery

Source: Baek GH, Kim JH, Chung MSW, et al. The natural history of pediatric trigger thumb. J Bone Joint Surg Am. 2008;90A(5):980–985; doi:10.2106/JBJS.G.00296[Abstract/Free Full Text]

The first 20% of the full text of this article appears below.


PICO

Question: What is the frequency and rate of spontaneous resolution of trigger thumb in children presenting to a university pediatric orthopedic practice?

Question type: Prognosis

Study design: Prospective case series

 

The authors, from the orthopedic service at the Seoul National University College of Medicine, Seoul, South Korea, sought to describe the natural history of trigger thumb, which usually presents in children as a flexion deformity of the interphalangeal (IP) joint.

They prospectively followed 55 children with 73 trigger thumb deformities over a 10-year period. No child received treatment. The amount of flexion deformity at the thumb IP joint was measured at every-six-month follow-up visits.

Parents of two children ultimately requested surgical management, leaving the final study cohort of 53 children with 71 trigger thumbs. The median age at presentation was 23 (range 1–55) months and the median follow-up was 48 (range 24–114) months.

Thirty children presented initially with bilateral involvement or with unilateral involvement plus a history of previous resolution of the other side. The initial average IP joint flexion deformity was 26 degrees which . . . [Full Text of this Article]

Richard M. Schwend, MD, FAAP
Pediatric Orthopaedics, Children’s Mercy Hospital, Kansas City, MO