1. Serviço de Ortopedia, Hospital Distrital de Santarém, Santarém, Portugal
2. Serviço de Ortopedia, Hospital de Santo André, Centro Hospitalar de Leiria, Leiria, Portugal
3. Serviço de Medicina Física e Reabilitação, Hospital de São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
4. Serviço de Ortopedia Infantil, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
5. Serviço de Medicina Física e Reabilitação, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
- Publicação no Portuguese Journal of Pediatrics (DOI: https://doi.org/10.25754/pjp.2020.17929)
Introduction: Pediatric trigger thumb is an uncommon condition. The aim of this study was to evaluate the outcome of our conservative treatment protocol for pediatric trigger thumb.
Methods: Retrospective study on a group of children with trigger thumb who were treated by the same physiatrist. From 2008 to 2018, the same conservative treatment protocol was used for all the patients. It consisted of using a splint and passive exercises. Splint application terminated either when the patient gained full range of active motion without snapping or underwent surgical intervention.
Results: 126 trigger thumbs in 98 children were treated according to our protocol. Mean age at first observation was 33.0 ± 18.1 months. At diagnosis, 27.8% of the thumbs were grade 1, 60.3% were grade 2, and 11.9% were grade 3. The average follow-up was 10.8 ± 6.4 months. At the final visit, 71.4% of the thumbs were grade 0A and 17.5% were grade 0B. The remaining thumbs either could be extended actively despite triggering (7.9%) or only passively (2.4%). Just one case (0.8%) had complete blocking. Our treatment protocol presented a high rate of satisfactory results, with 93.7% of patients having complete symptom resolution. The success rate was higher in the younger group. Bilateral cases and initial grade 3 trigger thumb were not associated with worse outcomes.
Discussion: Conservative treatment of pediatric trigger thumb showed a high rate of success. This is important information to emphasize and be passed on to parents so that they may avoid unnecessary surgery in many cases.
Palavras Chave: Child; Conservative Treatment; Exercise Therapy; Treatment Outcome; Trigger Finger Disorder/therapy