Triggerthumb
Trigger finger or trigger thumb is a condition that causes your fingers or thumb get stuck in a bent position. Those with trigger finger or trigger thumb may have stiffness when bending the finger(s) or hear snapping and popping when moving the finger(s). It is often seen in young children and in persons above 50 years though it may affect any age group.
The structure which helps to bend the thumb is known as tendon. At the base of finger, the tendon passes through a tunnel like structure , known as pulley. When the size of tendon becomes more than that of the pulley, the tendon does not easily glide. It can get stuck and produce a noticeable click or pop
Olden days this condition was thought to be congenital (child is born with the hand problem), when it involves children. But many studies have suggested that trigger thumb is not present at birth but rather develops with postnatal growth.
Furthermore , the term trigger is inaccurate because the vast majority of children present with a bend in the thumb. Trigger is apt in adults as the tendon triggers as the person tries to bend and straighten the thumb.
The precise timing of surgery is dependent on multiple factors, including the age of the child, degree of deformity and patience of the family. A delay in surgery upto 2 years of age in a child is not detrimental . only children with painful triggering and rigid deformity are advised surgery before 2 years of age.
Adults often present with noticeable click or pop in. Majority of the children present with bend deformity of tip ofg thumb.
Some period of observation is reasonable, especially in children less than 1 year of age. A delay in surgery upto 2 years of age is not detrimental . Upto 30% of children diagnosed prior to 1 year of age , resolve spontaneously before 2 years.
The precise timing of surgery is dependent on multiple factors, including the age of the child, degree of deformity and patience of the family. A delay in surgery upto 2 years of age in a child is not detrimental . only children with painful triggering and rigid deformity are advised surgery before 2 years of age.
In adults different treatment modalities are tried. Activity modification, massaging and splinting are tried initially. In non diabetic patients , injection of cortico steroid is attempted. Recurrence may occur after the injection. Surgical release is a minor day care procedure in adults. Patient gets immediate relief and recurrences are extremely rare.