Acta Chir Orthop Traumatol Cech. 2025; 92(3):147-152 | DOI: 10.55095/achot2024/058

Funtional Outcomes of Pediatric Trigger Digits – Outcomes of Two CentersOriginal papers

MARTIN VLACH1, 2, DAVID MÁŠKA1, ALENA SCHMORANZOVÁ2, ELIŠKA KŠÍROVÁ3, VOJTĚCH HAVLAS1
1 Klinika dětské a dospělé ortopedie a traumatologie 2. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice v Motole, Praha
2 Ústav chirurgie ruky a plastické chirurgie, p. o., Vysoké nad Jizerou
3 Ústav bioinformatiky 2. lékařské fakulty Univerzity Karlovy, Praha

Purpose of the study: The study evaluates the functional outcomes of the treatment of pediatric trigger digits in two centers and compares them with data from the available literature. The secondary objective is to verify the possibilities of collecting data on patients' health status through questionnaire surveys using remote communication via a web interface.

Material and methods: Patients operated on at the Hand and Plastic Surgery Institute in Vysoké nad Jizerou (ÚCHRaPCH) and the Motol University Hospital, Department of Orthopaedics (FNM) between 2018 and 2021 were evaluated. An analysis of demographic data, affected digits, and an assessment of functional outcomes using the Quick-DASH questionnaire were performed. The data were collected through Google Forms and then statistically analyzed. The subgroups were compared using the chi-square test and two-tailed unpaired t-test and logistic regression with Firth's correction was used to compare the obtained Quick-DASH scores.

Results: A total of 124 trigger digits in 102 patients were evaluated, including 113 thumbs and 11 fingers; bilateral findings were observed in 20.6% of patients. The mean age at the time of surgery was 3.7 years. The questionnaire was completed by 57.8% of patients treated at ÚCHRaPCH and 57.9% at FNM. The median Quick-DASH score was 0.0, indicating no disability or hand function limitation. The average Quick-DASH score was 1.7. No significant differences were found between the centers in demographic parameters or achieved scores. The prevalence of a non-zero Quick-DASH score was 24%.

Discussion: Our results, in line with global literature, confirm that surgical release of the A1 pulley is an effective method for treating pediatric trigger thumb or fingers with minimal complications. The online questionnaire survey proved beneficial for data collection. The limitation is the low response rate and the unavailability of suitable validated questionnaires for the given age group. The relatively high risk of a non-zero Quick-DASH score may be influenced by the inappropriate choice of questionnaire given the age of the subjects. An advantage of the data collection method used is the ability to require full completion of the questionnaire before submission, thereby eliminating the need to discard incomplete questionnaires.

Conclusions: Surgical treatment of pediatric trigger digits provides excellent outcomes, and the use of online questionnaires is suitable for health data collection. Further research is needed to validate questionnaires for pediatric age categories and subsequently to expand the concept of web-based data collection.

Keywords: trigger finger, child, questionnaire, Quick-DASH, functional outcomes, trigger thumb.

Received: October 8, 2024; Revised: October 8, 2024; Accepted: October 21, 2024; Published: July 1, 2025  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
VLACH M, MÁŠKA D, SCHMORANZOVÁ A, KŠÍROVÁ E, HAVLAS V. Funtional Outcomes of Pediatric Trigger Digits – Outcomes of Two Centers. Acta Chir Orthop Traumatol Cech. 2025;92(3):147-152. doi: 10.55095/achot2024/058. PubMed PMID: 40874796.
Download citation

References

  1. Ahmadi S, Akbari H, Shafaei Y, Akbari P. triggerthumb in twins: case report. World J Plast Surg. 2021;10:110-114. Go to original source...
  2. Baek GH, Kim JH, Chung MS, Kang SB, Lee YH, Gong HS. The natural history of pediatric trigger thumb. J Bone Joint Surg Am. 2008;90:980-985. Go to original source... Go to PubMed...
  3. Bauer AS, Bae DS. Pediatric Trigger Digits. J Hand Surg Am. 2015;40:2304-2309. Go to original source... Go to PubMed...
  4. Bayat A, Shaaban H, Giakas G, Lees VC. The pulley system of the thumb: anatomic and biomechanical study. J Hand Surg Am. 2002;27:628-635. Go to original source... Go to PubMed...
  5. Dinham JM, Meggitt BF. Trigger thumbs in children. A review of the natural history and indications for treatment in 105 patients. J Bone Joint Surg Br. 1974;56:153-155.
  6. Fernandes C, Dong K, Rayan G. Paediatric trigger-locked thumb. J Hand Surg Asian Pac Vol. 2022;27:2-9. Go to original source... Go to PubMed...
  7. Kay SPJ, Lees VC. Anomalies of the Tendons. In: Gupta A, Scheker LR, Kay SPJ (eds). The growing hand: diagnosis and management of the upper extremity in children. Mosby, London, 2000, pp 319-321.
  8. Kakel R, Van Heerden P, Gallagher B, Verniquet A. Pediatric trigger thumb in identical twins: congenital or acquired? Orthopedics. 2010;33:205-208. Go to original source... Go to PubMed...
  9. Kozin SH. Deformities of the Thumb. In: Wolfe SW, Pederson WC, Kozin SH, Cohen MS (eds). Green's operative hand surgery, 8th ed., Elsevier, Philadelphia, 2022, pp 1486-1488.
  10. Kuo M, Rayan GM. Complete annular and partial oblique pulley release for pediatric locked trigger thumb. Hand (NY). 2010;5:408-414. Go to original source... Go to PubMed...
  11. Marek DJ, Fitoussi F, Bohn DC, Van Heest AE. Surgical release of the pediatric trigger thumb. J Hand Surg Am. 2011;36:647-652. Go to original source... Go to PubMed...
  12. McAdams TR, Moneim MS, Omer GE Jr. Long-term follow-up of surgical release of the A(1) pulley in childhood trigger thumb. J Pediatr Orthop. 2002;22:41-43. Go to original source...
  13. Meyer VM, Benjamens S, Moumni ME, Lange JFM, Pol RA. global overview of response rates in patient and health care professional surveys in surgery: a systematic review. Ann Surg. 2022;275:75-81. Go to original source... Go to PubMed...
  14. Mixa V. Dětská anestezie 2016 - jistoty a rizika. Postgraduální medicína. 2016;18:465-469.
  15. Musálek M. Development of test baterries for diagnostics of motor laterality manifestation: link between cerebellar dominance and hand performance. Karolinum Press, Praha, 2014; pp 57-59. Go to original source...
  16. Nemoto K, Nemoto T, Terada N, Amako M, Kawaguchi M. Splint therapy for trigger thumb and finger in children. J Hand Surg Br. 1996;21:416-418. Go to original source... Go to PubMed...
  17. Prock-Gibbs H, Marshall BJ, Werntz JR. Pediatric trigger digits. Pediatr Rev. 2022;43:191-197. Go to original source... Go to PubMed...
  18. Rao V, Ericson WB Jr. Consequences of untreated pediatric trigger thumb: case report. Hand (NY). 2022;17:5-8. Go to original source... Go to PubMed...
  19. Rayhan RU, Zheng Y, Uddin E, Timbol C, Adewuyi O, Baraniuk JN. Administer and collect medical questionnaires with Google documents: a simple, safe, and free system. Appl Med Inform. 2013;33:12-21.
  20. Salloum NL, McGee P, Lam WL. The association between trauma and paediatric trigger thumb deformity; experience from a single tertiary referral hospital. J Plast Surg Hand Surg. 2023; 57:181-185. Go to original source... Go to PubMed...
  21. Schubert MF, Shah VS, Craig CL, Zeller JL. Varied anatomy of the thumb pulley system: implications for successful trigger thumb release. J Hand Surg Am. 2012;37:2278-2285. Go to original source... Go to PubMed...
  22. Shah AS, Bae DS. Management of pediatric trigger thumb and trigger finger. J Am Acad Orthop Surg. 2012;20:206-213. Go to original source... Go to PubMed...
  23. Sugimoto Y. Treatment of trigger digit in children. Seikei Geka. 1991;34:1047-1050.
  24. Tadisina KK, Francoisse CA, Frojo G, Gorski J, Plikaitis CM. Pediatric trigger digit presenting in the setting of trauma. Ann Plast Surg. 2021;87:427-430. Go to original source... Go to PubMed...
  25. Tordai P, Engkvist O. Trigger fingers in children. J Hand Surg Am. 1999;24:1162-1165. Go to original source... Go to PubMed...
  26. Twu J, Angeles J. Developmental trigger thumb. Pediatr Ann. 2016;45:135-138. Go to original source... Go to PubMed...
  27. Van Heest AE. Pediatric trigger thumb and finger. In: Abzug JM, Kozin SH, Zlotolow DA (eds). The pediatric upper extremity. Springer-Verlag, New York, 2015, pp 1735-1742. Go to original source...
  28. Venkatadass K, Bhardwaj P, Sabapathy SR. Pediatric trigger thumb: congenital or developmental? A Unique case report. J Hand Microsurg. 2020;12(Suppl 1):S75-S77. Go to original source... Go to PubMed...
  29. Vutskits L, Culley DJ. GAS, PANDA, and MASK: No evidence of clinical anesthetic neurotoxicity! Anesthesiology. 2019;131:762-764. Go to original source... Go to PubMed...
  30. Wilkerson JA, Strauch RJ. A simple technique for confirmation of complete release in surgical treatment of pediatric trigger thumb. J Hand Surg Am. 2014;39:2348-2349. Go to original source... Go to PubMed...
  31. Wilson J, Arshad F, Nnamoko N, Whiteman A, Ring J, Roy B. Patient-reported outcome measures: an on-line system empowering patient choice. J Am Med Inform Assoc. 2014;21:725-729. Go to original source... Go to PubMed...
  32. Wolf JM. Tendinopathy. In: Wolfe SW, Pederson WC, Kozin SH, Cohen MS. Green's operative hand surgery, 8th ed., Elsevier, Philadelphia, 2022, pp 2109.
  33. Yano K, Kaneshiro Y, Miyashima Y, Iwamae M, Sakanaka H. Surgical treatment for a 24-year-old patient with pediatric trigger thumb: A case report. J Orthop Sci. 2023;28:693-696. Go to original source... Go to PubMed...
  34. Yano K, Ikeda M, Yoneda M, Tokui A, Nakagawa K, Kaneshiro Y, Hosomi R, Kazuki K. Clinical results of splinting versus observation for pediatric trigger thumb. J Pediatr Orthop B. 2021;30:346-350. Go to original source... Go to PubMed...
  35. Zguricas J, de Raeymaecker DM, Snijders PJ, Hoekstra A, Lindhout D, Hovius SE. Psychomotor development in children with triphalangeal thumbs. A preliminary study. J Hand Surg Br. 1998;23:526-529. Go to original source... Go to PubMed...