Pediatric trigger digits

Trigger digits can affect anyone, at any age, in any digit. It involves the inability of the flexor tendon to glide smoothly through the ligamentous tunnel that surrounds it. In an adult, trigger digits cause clicking or sometimes locking of the digit, usually in the flexed (bent) position, but sometimes in the extended (straight) position. There is often pain associated with the unlocking of the digit.

In children, the symptoms are a little different. Sometimes babies are born with the affected digit (usually the thumb) locked in a flexed position. They do not complain of pain, and usually, the thumb cannot be straightened on its own accord, but sometimes can be straightened using the other hand, or by a parent. Sometimes the locked digit appears after a few months or even in the first few years of life, with no known cause. About 60% of pediatric trigger thumbs will resolve without treatment by the age of 4. Without treatment, the contracture can improve, even if it does not resolve. If the contracture remains, surgery can be performed to release the ligament that is blocking motion of the tendon. Surgery is done under general anesthesia, and the procedure takes about 15 minutes. It is an outpatient procedure, so you would be able to take your child home after the surgery.

Pediatric triggering of the fingers instead of the thumb, is usually a different entity anatomically, and requires further discussion. Surgery is not as reliable in trigger fingers as it is for pediatric trigger thumbs. Dr. Yu can discuss this in more detail, after examining your child’s fingers and assessing the nature of the problem.

  • American Society for Surgery of the Hand (ASSH)
  • American Academy of Orthopaedic Surgeons (AAOS)
  • The American Board of Orthopaedic Surgery (ABOS)