Document Detail

Pediatric trigger thumb with locked interphalangeal joint: can observation or splinting be a treatment option?
MedLine Citation:
PMID:  22955537     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: : The purpose of this study is to report the natural history of pediatric trigger thumb with locked interphalangeal joint, the efficacy of a splint for this condition, and the outcome of late surgery.
METHODS: : Medical records of 64 patients were retrospectively reviewed. Patients were treated with a coil splint when parents and patients accepted; otherwise, regular observation was conducted. Splint application and/or observation were terminated either when the patient gained full range of active motion without snapping, or underwent surgical intervention.
RESULTS: : In splint group, 92% of the patients experienced complete symptom relief in 22 months, whereas 60% resolved completely in 59 months in observation group. The differences were statistically significant. One thumb in a patient with bilateral involvement remained locked while the other completely resolved. The rest of the patients also showed improved symptom from locking to snapping. Four patients with residual snapping underwent surgery at the age of 8 years and above without any deformity and complication.
CONCLUSIONS: : Splint was efficient in shortening the time for symptom relief; however, the natural history revealed the self-limiting nature of this condition. Late surgery was safe and effective for residual snapping and can be presented as one treatment option to the patients and families, combined with conservative treatment.
LEVEL OF EVIDENCE: : Level III-retrospective comparative study.
Shukuki Koh; Emiko Horii; Tatsuya Hattori; Masayuki Hiroishi; Junko Otsuka
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric orthopedics     Volume:  32     ISSN:  1539-2570     ISO Abbreviation:  J Pediatr Orthop     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109053     Medline TA:  J Pediatr Orthop     Country:  United States    
Other Details:
Languages:  eng     Pagination:  724-6     Citation Subset:  IM    
*Department of Orthopedic Surgery, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya †Hattori Orthopedics & Dermatology, Aichi, Japan.
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