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Understanding Trigger Thumb

What is it?


Tendons are attached to your bone and held against the bone by pulleys or “loops”. Tendons bend and straighten our fingers and thumbs. A lump develops on the tendon in trigger thumb. As the tendon moves up and down with straightening and bending the thumb, the lump catches on the pulleys, causing either popping or the thumb sticking bent or straight.

Causes


The cause for pediatric trigger thumb is unknown.

Symptoms


Your child may not experience pain when the thumb is stuck. Some children are able to manually straighten or bend their thumb with their other hand.

Who may be affected?


Adults and children may get trigger thumb, but in children it is usually not due to inflammation. It is not commonly painful. However, it can be annoying or may begin to disrupt their normal activities.

Diagnosis


X-rays are not needed for diagnosing trigger thumb. The bones and joints are normal. It is an issue with the tendon, which cannot be seen on x-ray. The diagnosis is made by examining your child.

Treatment


As the child gets older, the trigger thumb may affect their activities of daily living. Sometimes pediatric trigger thumb can resolve on its own as the child grows. Watching and waiting is usually the first step. Treatment options include surgery or splinting. Surgery is preferred because splinting needs to be done for long periods of time for nearly a year to be useful. Surgery usually requires your child to be put under anesthesia and is performed in the Operating Room.