Nguyen Ngoc Hung*, Hoang Hai Duc, Le Tuan Anh, Phung Cong Sang and Nguyen Vu Hoang

Department of Hong Phat General Hospital; Hanoi Medical University, Vietnam

*Corresponding Author: Khondker Qamruzzaman, Associate Professor, Department of Paediatrics, SSMC and Mitford Hospital, Dhaka, Bangladesh.

Received: September 19, 2023; Published: September 27, 2023

Abstract

Purpose: To report the surgical treatment outcome of pediatric locked trigger thumb by sequential release of the annular pulley and partial release of the oblique pulley.

Materials and Methods: A retrospective review was undertaken on 55 operative thumbs in 42 patients with an average follow-up of 55 months. Intraoperative observations focused on the pathology of the pulley system. Surgical technique involved complete release of the annular pulley A1, along with release of the proximal 50% of the oblique pulley in all patients. Postoperative parameters of bowstringing, resolution of Notta's node, thumb interphalangeal motion, and patient parent satisfaction were assessed.

Results: There ware 42 patient, 55 thumb were operated. Boy: 16; Girl: 13. Right: 15; Left: 14. Age onset: 4.0 ± 2.269 months, onset in bilateral group (61.5%) earlier more unilateral (29%) (Pvaluate: 0.0195); Age at Diagnosis: 11.75 ± 3.491 nonths, ; Classification of trigger thumb: Type 2: 6, Type 3: 23, group bilateral with Type 3 (69.2%) more unilateral group (10.3%) (Pvaluate: 0.02104) ; Age at Operation: 21.620 ± 7.970 ( ≤ 12 moths: 3. > 12 - ≤ 36 months: 49. > 36 months: 3) operative under 18 months in bilateral group (37.9%) more unilateral group (7.7%) (Pvaluate:0.0157); Follow-Up time 50.1 months, Good 90.9%, Fair: 9.1%. (bilateral beter unilateral group (Pvaluate: 0.0185). No patients had recurrence of thumb locking or triggering. No bowstringing was detected, and Notta’s node resolved fully in 28 of 55 thumbs. All patients or families expressed overall satisfaction with the procedure.

Conclusion: Mistaking the constricted proximal oblique pulley for an annular pulley may encourage releasing the entire oblique pulley, leading to an adverse result. Satisfactory outcome was achieved after surgical treatment of pediatric locked trigger thumbs.

Keywords: Congenital Trigger Thumb; Locked Thumb; Oblique Pulley; Annular Pulley

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Citation

Citation: Nguyen Ngoc Hung., et al. “Treatment Outcome of Trigger Thumb in Children".Acta Scientific Orthopaedics 6.10 (2023): 62-76.

Copyright

Copyright: © 2023 Nguyen Ngoc Hung., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.