The Development of Trigger Thumb in the Contralateral Thumb in Pediatric Patients Presenting Initially With Unilateral Involvement
| Autor: | Julie Balch Samora, James E. Popp, Robert Pettit, James S Lin, Joseph A Rosenbaum |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
030230 surgery Thumb Unilateral disease 03 medical and health sciences 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Range of Motion Articular Trigger thumb Hand clinic Child Retrospective Studies Surgery Articles Flexion contracture 030222 orthopedics business.industry Hand Surgery body regions medicine.anatomical_structure Trigger Finger Disorder Laterality Presentation (obstetrics) business Range of motion |
| Zdroj: | Hand (N Y) |
| ISSN: | 1558-9455 1558-9447 |
| DOI: | 10.1177/1558944719864449 |
| Popis: | Background: Pediatric trigger thumb is a common condition that can occur bilaterally. There have been reports of a metachronous relationship between trigger thumbs developing in both extremities. Surgeons might consider delaying operative treatment of unilateral trigger thumb due to the concern that contralateral symptoms may develop later in childhood, requiring a second procedure and anesthetic event. Methods: We retrospectively reviewed patients diagnosed with pediatric trigger thumb from 2008 to 2016 at a large pediatric hospital. Data collected included age at presentation and onset, laterality, age and timing of onset of contralateral symptoms, time of index procedure and subsequent procedure (if any), severity of symptoms, previous treatments, range of motion, and birth history. Results: There were 198 patients with pediatric trigger thumb, with 55 patients (28%) presenting with or developing bilateral involvement. Fifty patients (25%) had bilateral involvement upon initial presentation. Five patients (3%) were subsequently diagnosed with contralateral trigger thumb after initial presentation of unilateral trigger thumb. Average time to contralateral trigger thumb development was 12 months after presentation in unilateral patients. Most patients presented with locked flexion contracture with palpable Notta’s nodule. Of the 5 patients who developed contralateral trigger thumbs, three required a second surgery after the index procedure. Conclusions: The vast majority of patients with bilateral trigger thumbs had bilateral involvement upon initial presentation to the pediatric hand clinic. Given the rarity of bilateral symptoms after initial unilateral presentation, we do not recommend delayed surgical intervention for patients with unilateral disease in children over 3 years of age. |
| Databáze: | OpenAIRE |
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