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HealthInfo West Coast-Te Tai Poutini

How is trigger thumb treated?

baby handChildren with trigger thumb can usually use their hands normally. And in more than half of cases, their thumb will become straight again without any medical treatment.

If your child's thumb is still bent when they are 18 months old, if they are not using their hand properly, or if they say their thumb hurts, they may need to see a plastic or orthopaedic (bone) surgeon. Ask your GP about being referred.

What can I do to help my child's trigger thumb?

Using splints or taping your child's thumb usually doesn't help.

Taking regular photos of your child's thumb, to monitor progress, can help. This can show doctors how your child's thumb is progressing and, if it becomes locked in a bent position, can help to pinpoint when that happened.

If their thumb isn't locked in a bent position (so you can straighten it, or they can straighten it with their other hand), massage and stretches can help to free the nodule. To stretch their thumb, apply gentle pressure to the tip of their thumb and try to straighten it. To massage it, massage at the base of the thumb where you can feel the nodule. Massage can help the tendon to move past the A1 pulley.

Surgery for trigger thumb

If stretching isn't enough, your child will need an operation called a trigger thumb release, or an A1 pulley release. This is done as day surgery, so your child will not need to stay overnight in hospital. The operation is done with a general anaesthetic (meaning your child will go to sleep), but it is very quick. Your child's surgeon will discuss the risks and benefits of this surgery with you.

The surgeon will make a small cut (incision) in the crease of skin at the base of your child's thumb. Then they will widen the entrance of the tunnel by cutting through (releasing) this AI pulley. This takes pressure off the tendon and allows it to glide smoothly. The surgeon will not cut into the tendon or remove the nodule.

After surgery, your child will need a bandage for one to two weeks to protect their thumb while it heals. It's important to keep their hand clean and dry during this time to stop them from getting an infection.

Trigger thumb is unlikely to come back, and your child will probably not need any other treatment for it. Once they have healed, you can expect your child to have normal use of their thumb.

When should I take my child back to the GP?

Important

After surgery you should take your child to the GP if you have any concerns or notice any signs of infection. These include:

Also return to your GP if your child is not using their hand normally within two weeks of the wound healing and the bandage coming off, or if the trigger thumb comes back.

Written by HealthInfo clinical advisers. Endorsed by orthopaedic surgeon, Canterbury DHB. Page created July 2017.

Sources

Page reference: 380390

Review key: HIWHC-380375