Pediatric Trigger Thumb

Department of Orthopaedic Surgery, Children's Hospital, Boston, MA 02115, USA.
The Journal of hand surgery (Impact Factor: 1.67). 10/2008; 33(7):1189-91. DOI: 10.1016/j.jhsa.2008.04.017
Source: PubMed
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    ABSTRACT: The term "failure of differentiation" describes the phenotypes of a large number of otherwise unrelated conditions. The six conditions described here (arthrogryposis, camptodactyly, clinodactyly, Madelung deformity, trigger finger, and trigger thumb) are believed to occur because various structures failed to differentiate normally; however, they have neither common features nor a common cause. We have included information about the history and diagnosis of these conditions, the cause (if known), and the current concepts of treatment and expected outcomes.
    Hand clinics 06/2009; 25(2):195-213. DOI:10.1016/j.hcl.2008.12.003 · 1.26 Impact Factor
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    ABSTRACT: Possible ethnic differences in the incidence of trigger thumb have not been studied in the literature. The authors' purpose was to examine the demographic characteristics of pediatric trigger thumb at a large urban medical center with a diverse patient population. The electronic medical records were reviewed for all children with trigger digit seen at Children's Medical Center Hand Clinic in Dallas from September of 2005 to May of 2008. All patients with trigger thumb were included in the study, and patients with trigger digit(s) alone were excluded. Population distributions were analyzed using chi-square analysis. Relative incidences were calculated and compared using the binomial method of standard error calculation. A total of 97 patients with trigger digit(s) were identified. Of those, there were 87 patients with 96 trigger thumbs. The ethnic distribution of the trigger thumb group was 18 percent white, 7 percent black, 56 percent Hispanic, and 18 percent other. During the same time period, the authors' clinic evaluated 6667 new patients with an ethnic distribution of 26 percent white, 18 percent black, 38 percent Hispanic, and 18 percent other. A chi-square analysis comparing the ratios of the two groups revealed a value of p = 0.004. Overall trigger thumb incidence in our clinic was 1.3 percent, with ethnic breakdown of white, 0.9 percent; black, 0.5 percent; Hispanic, 1.9 percent; and other, 1.3 percent. The standard error was 0.14 percent, with a 95 percent confidence interval of 1.02 to 1.58 percent. There was a higher incidence of trigger thumb in the Hispanic population. A lower incidence among blacks with trigger thumb was also noted.
    Plastic and Reconstructive Surgery 10/2009; 124(4):1221-4. DOI:10.1097/PRS.0b013e3181b59ac1 · 2.99 Impact Factor
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    ABSTRACT: OBJECTIVE. To evaluate results from surgical release of trigger thumbs in children in a regional hospital cluster in Hong Kong. DESIGN. Descriptive case series. SETTING. A regional hospital cluster, Hong Kong. PATIENTS. Data from 1993 to 2009 on 180 children with 209 trigger thumbs were collected. Analyses into gender, predominance of thumb, age of onset, associated abnormalities and family history, symptoms and signs, surgical outcomes, and postoperative complications were carried out retrospectively. RESULTS. There were 92 girls and 88 boys having trigger thumbs (1.05:1). In all, 29 (16%) of the children presented with bilateral trigger thumbs, while the right thumb was singly involved in 81 (45%) and the left thumb in 70 (39%) of the children. The mean age of onset was 19 months; only 20% were diagnosed before the age of 1 year. Only nine (5%) of the children were associated with congenital diseases and none had a positive family history of trigger thumb. Flexion deformity was the major presenting feature, other than triggering or pain. A nodule and flexion deformity were very commonly observed during physical examination. More than 95% of the operated thumbs with transverse incision acquired a good range of movement with a scarcely apparent scar. A residual flexion deformity was evident in only 4%, mostly in children who underwent surgical release under the age of 1 year. CONCLUSION. Surgical release is recommended for children with trigger thumbs aged more than 1 year, which attains satisfactory results with minimal complications.
    Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine 10/2011; 17(5):372-5. · 0.87 Impact Factor
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