Trigger thumb is a condition where a child’s thumb catches, locks or snaps when they try to move it. This common hand condition can make it hard for children to use their thumb normally.
At Banner Children’s, we understand how important it is for your child to have full use of their hand. Our pediatric hand specialists are experts in treating trigger thumb. We offer expert care to help your child’s thumb move smoothly.
Trigger thumb in children, also known as pediatric trigger thumb, happens when the flexor tendon - the tendon that helps bend the thumb - can’t move smoothly. This condition is a type of congenital hand difference and is common in babies and toddlers. It is not the same as trigger finger or trigger thumb in adults.
The muscle that bends the thumb is called the flexor pollicis longus. It starts in the forearm and becomes a tendon that runs through the palm to the tip of the thumb. The tendon slides inside a tunnel called a tendon sheath.
Near the base of the thumb, a tight band of tissue called the A1 pulley helps hold the tendon close to the bone. In trigger thumb, the tendon becomes swollen and forms a bump, or nodule. This bump catches at the A1 pulley, making it hard to move the thumb. The thumb may click, catch or lock in a bent position.
You might feel this bump on your child’s palm. Sometimes the thumb stays stuck and won’t straighten without help.
Trigger thumb can affect one or both thumbs. The condition may improve on its own in some cases, but other times it needs treatment to help the tendon move freely again.
There are two types of trigger thumb in children:
Triggering can also happen to the fingers, but that’s a separate condition.
The exact cause of trigger thumb in children is often not clear. But the main problem is that the tendon sheath isn’t wide enough or gets swollen. It isn’t caused by an injury or something the child did.
You might notice your child’s thumb:
Many children don’t complain of pain, especially at first. But some may start to avoid using the thumb because it feels stiff or uncomfortable. Contact your child’s health care provider or a pediatric hand specialist if you notice any signs.
Trigger thumb can be diagnosed by your child’s health care provider through a physical exam. They will feel around the base of the thumb to check for lumps or bumps. They will check if the thumb locks or snaps during movement. Usually, no X-rays or imaging scans are needed.
If your child has trigger thumb, their provider will refer you to a pediatric hand specialist or orthopedic surgeon.
Treatment for trigger thumb depends on your child’s age and how severe the condition is. In many cases, it can get better on its own without surgery.
For children younger than 2, sometimes the trigger thumb will get better on its own. The provider may recommend watching your child for several months to see if the problem improves without treatment.
If the trigger finger doesn’t go away on its own, it can get stuck or locked. This can lead to a contracture (permanent shortening of the muscle or tendon).
If the condition doesn’t improve or your child is older, the provider may suggest a splint. A splint holds the thumb straight to prevent catching and help the tendon sheath loosen.
You may also be shown gentle exercises to do at home. These help the tendon move more freely.
If the splint and exercises don’t work, or if your child’s thumb stays locked, surgery may be the best option. The surgery is called a trigger thumb release or A1 pulley release.
During this simple surgery, the surgeon makes a small cut near the base of the thumb. They release the tight sheath so the tendon can slide easily again. The surgeon doesn’t cut into the tendon or remove the bump.
After surgery, your child will need a cast to protect and stretch the thumb while it heals. Recovery is usually quick and your child should regain full thumb movement.
Most children recover full motion and use of their thumb after treatment and surgery. It is rare for the condition to return. If it does, your child’s provider may look for other possible causes or recommend further treatment.
At Banner Children’s, we care for your child like family. Our pediatric hand specialists have years of experience treating trigger thumb and other limb differences.
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If your child has been diagnosed with trigger thumb or you notice signs that concern you, don’t wait to get help. Early treatment can make a difference in your child’s growth and development.
Schedule an appointment with a Banner Children’s specialist today. We’re here to answer your questions, explain your options and help your child live their healthiest life.
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