Trigger Thumb

In very young children, trigger thumb or finger will resolve on its own for up to 30 percent of children before they reach their first birthday. After that age, it’s unlikely this condition will go away without treatment. Ultrasound can help confirm the diagnosis by demonstrating the node on their tendon.

Surgery to correct trigger thumb is usually performed when a child is between 1 to 2 years of age (before 3 years). In this procedure, your child’s surgeon will release the tendon from the tendon sheath where it is catching, allowing the tendon to glide more smoothly.

Treatment of trigger fingers other than the thumb will include evaluation for any underlying inflammatory condition. Treatment most commonly involves releasing one of the tendon pulleys of the thumb to allow the tendon to glide more smoothly. There are important nerves and vessels nearby, which is why it is important that the surgery is performed by a qualified hand surgeon, like those at RPS.

Your child will be able to go home the same day as her trigger finger or trigger thumb release surgery. She will need to leave a soft dressing over the incision for five days after surgery. Use of the affected hand will be restricted during this time, but they should be able to return to more normal movement and activity within a few weeks.

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What are the signs and symptoms of Trigger Thumb in my child?

Some common signs of trigger finger and thumb include:

Stiffness in the affected finger or thumb
A painful popping or clicking when the finger or thumb is bent and straightened
A finger or thumb that gets stuck in either a bent or straight position
Symptoms that are worse in the morning

In some cases, these symptoms may be associated with an inflammatory condition such as juvenile idiopathic arthritis.

What is the treatment for Trigger Thumb for my child?

Surgery to correct trigger thumb is usually performed before your child turns 3 years of age. In this procedure, your child’s surgeon will release the tendon from the tendon sheath where it is catching, allowing the tendon to glide more smoothly.

Treatment of trigger fingers other than the thumb will include evaluation for any underlying inflammatory condition. Treatment may include surgical removal of a part of the tendon or decompressing the tendon sheath to allow the tendon to glide more smoothly.

Once the dressing is removed, your child will be able to use her hand normally and without restriction. The absorbable sutures used during surgery will fall out on their own within two weeks of surgery.

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What else you should know

How will RPS manage my child's post-operative care?

RPS will give you specific advice regarding your child’s individual post-operative recovery. They will advise:

where your child will go after their surgery
what medication your child will be given or prescribed
what bandages and dressings your child will need and when they’ll be removed
when the stitches will dissolve or need to be removed
when your child can get back to normal activity and exercise
when to book follow-up care for my child

How do I care for my child at home?

After returning home from surgery you should follow the post-operative instructions provided by the RPS team.

Remember, everyone recovers differently, but you can follow these general steps to optimise healing.

Medicine

Always speak with your RPS team to find out when you can recommence giving your child any existing medication and before starting any new medicine they have prescribed.
Always consult the RPS team before taking new medication, even if it’s over-the-counter.
Always follow the instructions provided with the medication.

Activity

When you have stitches, always check with the RPS team before your child returns to their normal activities.
After a skin graft, any exercise that stretches the skin should be avoided for at least three weeks.

Caring for your child’s wound

The wound will have a dressing covering it to help it heal and protect it from outside elements. If your child had a skin graft you may need to change the bandages. The post-operative instructions given to you will outline how to care for your child’s wound.
If your child had stitches, the RPS team will let you know when or if you have to return to have them removed. In most cases, absorbable (dissolving) sutures are used in children so they do not have to have sutures removed.
Wash the area daily with warm, soapy water and pat it dry. Ensure you don’t use any alcohol or hydrogen peroxide which can slow down the healing process.

When should I call for help?

Notify your health care team immediately if your child experiences any of the following symptoms:

nausea, vomiting or diarrhoea
fever/high temperature – 38°C or higher
your child’s stitches become loose or the wound opens
increasing pain that doesn’t improve with medication
increasing warmth, swelling or redness around incision site
pus coming from the incision site
heavy bleeding from incision site
red streaks leading to the incision site
your child can’t pass stools or gas
signs of a blood clot including pain in the calf, back of the knee, groin or thigh, redness or swelling in their leg.

If your child faints or is short of breath call 000 for emergency care.