Abstract
Pediatric trigger thumb is caused by a developmental size mismatch between the flexor pollicis longus tendon and its sheath. Children generally present around age 2 with fixed flexion deformity of the thumb interphalangeal joint or with triggering with flexion and extension of the interphalangeal joint. Characteristically, Notta’s nodule is palpable on the tendon near the metacarpal phalangeal joint. The American Academy of Orthopedic Surgeons (AAOS) recommends surgical A1 pulley release for all children over the age of 12 months presenting with fixed flexion contractures. Observation may be pursued if the caretaker prefers nonsurgical management because there is no evidence that links the duration of symptoms with post-operative loss of interphalangeal motion. However, the AAOS recommends discontinuing nonsurgical measures after 2 years because there is limited potential for spontaneous recovery beyond this period.
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Qin, M.M., Nicolay, R.W. (2023). Trigger Thumb. In: Sarwark, J.F., Carl, R.L. (eds) Orthopaedics for the Newborn and Young Child. Springer, Cham. https://doi.org/10.1007/978-3-031-11136-5_13
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DOI: https://doi.org/10.1007/978-3-031-11136-5_13
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