Treatment and Diagnosis of Pediatric Trigger Thumb (S2:E20)

Orthopedic specialists don't know what causes trigger thumb in children, but they do know there are different pathologies for trigger thumb in children and adults, and that differing pathologies require different treatments. Fortunately, while pediatric trigger thumb can be subtle, the condition is one of the easiest pediatric diagnoses to make.

Listen to our experts discuss pediatric trigger thumb treatment

Today's episode of Charting Pediatrics explores pediatric trigger thumb (also known as trigger finger, flexor tenosynovitis or stenosing tenosynovitis) with Sarah Sibbel, MD. Dr. Sibbel is the Director of the Pediatric Hand and Upper Extremity Program and Surgical Director of the Brachial Plexus Clinic at Children's Hospital Colorado.

In this episode, our pediatric experts:

• Define pediatric trigger thumb and the path of physiology
• Explain the diagnosis of pediatric trigger thumb in primary care and suggest helpful imaging to obtain to assist in the diagnosis
• Share operative and nonoperative treatment plans and their associated risks
• Discuss the success rate of trigger finger surgery as a treatment
• Explain the time-optimal period between observation and surgery for trigger thumb in children
• Reassure listeners about how trigger thumb impacts a child's day-to-day life
• Reflect on the roles for nonsteroidal anti-inflammatory agents in trigger thumb treatment for children
• Share helpful follow-up plans for the outpatient setting

Understanding trigger thumb in children

Often, parents will first notice a trigger thumb when they see that their child can't give a full thumbs up. Other times, an injury draws attention to the affected thumb. As our expert explains, the first step in trigger thumb treatment is observation. There's a strong likelihood of spontaneous recovery, particularly if the child is under two years old and the trigger thumb has been present for less than one year.

Sometimes, treatment is needed, and Dr. Sibbel explains the most commonly prescribed treatment options that are available.

Pediatric trigger thumb treatment and surgery

If trigger thumb treatment is needed, several options are nonsurgical. Gentle stretching, massage and splinting are all commonly recommended therapies. If splinting is the chosen treatment, pediatricians should understand that it can be disruptive at bedtime. If the child needs surgery, parents and practitioners alike can find comfort in the procedure's high success rate. After treatment, trigger thumb should not hold the child back from participating in their favorite sports and activities.

Experienced primary care providers are encouraged to discuss treatment options and outcomes with families, though Dr. Sibbel emphasizes that specialists are more than happy to see a patient at any time.

Pediatric trigger thumb treatment and management at Children's Colorado

Children with trigger thumb are treated by our Hand and Upper Extremity Program team. Our pediatric orthopedic hand surgeons offer a wide range of services for the diagnosis, treatment and management of pediatric trigger thumb. Refer a patient to Children's Colorado.