Trigger thumb, a condition that limits thumb movement in children, is often characterized by a clicking sensation. While the condition is most often treated without surgery in non-severe cases, it can be a source of pain and frustration for your child. Understanding the causes and benefits of treatment will help you make better-informed choices with your child's doctor to alleviate symptoms and prevent potential complications.
Identification
Trigger thumb is a condition in which your child's thumb locks or clicks as it moves from a bent to straight position, Children's Hospital Boston says. In severe cases, it may become locked in the bent position. An estimated 2.2 percent of all upper extremity anomalies in children are from trigger thumb, according to a 2008 article in "The Journal of Bone and Joint Surgery."
Causes
Trigger thumb is caused when flexor tendons, tendons that control the movement of the thumb, become inflamed and swollen, "The Merck Manual Home Health Handbook." The inflammation makes it is more difficult for the tendons to slide through the surrounding sheath that guides its movement when your child tries to straighten his thumb. This causes the thumb to lock in the bent position. The exact cause is not known. According to Donald S. Bae in a September 2008 issue of "The Journal of Hand Surgery," scientific evidence suggests children are not born with the condition but acquire it during childhood.
Symptoms
Symptoms of trigger thumb include finger locking in the bent position, pain and swelling, a popping or clicking sensation during thumb movement and a bump at the base of the thumb, the MayoClinic.com says. Additionally, your child's thumb may be stiff in the morning compared with the rest of the day.
Diagnosis
A doctor will determine if your child has trigger thumb by conducting a physical exam and taking a thorough medical history. While X-rays are not required, the doctor will check your child's hand for stiffness and pain, and look for locking during thumb movement. In some cases, a local anesthetic may be required to alleviate pain and allow the doctor to conduct a physical exam.
Treatment
Nonsurgical and surgical treatment options are available to treat trigger thumb. Your child's doctor may advise resting your child's thumb by using a splint if symptoms are mild, the American Academy of Orthopaedic Surgeons advises. Gentle massage and finger exercises may also be helpful. According to Donald S. Bae in a 2008 issue of "The Journal of Hand Surgery," published scientific reports suggest the condition spontaneously resolves in up to 66 percent of cases in children.
In severe cases in children, surgery is often considered to widen the opening of the sheath tunnel to allow the thumb to pass through without restriction.
References
- Children's Hospital Boston: Trigger Thumb
- MayoClinic: Trigger Finger
- "The Journal of Bone and Joint Surgery"; The natural history of pediatric trigger thumb; Goo Hyun Baek et al.; May 2008
- "The Merck Manual Home Health Handbook"; Robert S. Porter et al.; 2009
- American Academy of Orthopaedic Surgeons: Trigger Finger
