Abstract
Aims: trigger digit is a common problem in young children. Open longitudinal section of the A1 pulley is considered standard treatment. In adults, percutaneous release under local anaesthesia has been reported as an effective and safe technique. The purpose of this study is to evaluate the percutaneous technique in a paediatric population. Methods: fourteen consecutive patients with 16 trigger thumbs and a mean age of 2.5 years (range 7 months to 4.6 years) were operated with a percutaneous technique under sedation in an ambulatory setting. Surgical technique consists in puncturing with a intramuscular needle in the middle of the palmar crease of the þrst metacarpofalangeal joint; the ßexor tendon is transþxed and the thumb is moved to conþrm the position. The needle is pulled slightly and moved in a longitudinal fashion to section the pulley, The needle is pulled completely and the release is conþrmed clinically. Parents were instructed to constantly move the released thumb along the þrst postoperative week. Results: After a mean follow up of 25 months (range 6 to 65 months), 14 þngers had normal range of motion and no triggering. One patient presented occasional triggering after surgery that disappeared 5 months after and was considered a good result. One patient presented recurrence of the interphalangeal block and required open release 30 days after the initial surgery. No vascular or neural deþ-cits were observed. Conclusions: Percutaneous release is an effective technique in paediatric trigger thumb. Good results were obtained in 94% of the patients. The case that required reoperation can be attributed to the learning curve.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
