Surgical treatment of the pediatric trigger finger.

PURPOSE

The purpose of this investigation is to assess the efficacy of a standardized surgical technique in the treatment of symptomatic trigger fingers in pediatric patients.

METHODS

A retrospective study was performed of 18 consecutive patients with 23 trigger fingers treated at our institution between 1996 and 2006. Average age at the time of presentation was 4.5 years (range, 1-12 years). Involved digits included 2 index, 12 long, 3 ring, and 6 small fingers. All patients had surgical treatment consisting of A1 pulley release and resection of a single slip of the flexor digitorum superficialis (FDS) tendon. Average clinical follow-up evaluation was 43 months (range, 3-111 months).

RESULTS

In almost half of the cases, triggering was noted to occur at the level of the FDS tendon decussation. In 9 cases, specific tendon pathology was observed, including fusiform thickening, nodular thickening, calcific tendonitis, and cyst formation. Overall, 21 of 23 (91%) fingers demonstrated successful resolution of triggering without recurrence after surgical treatment. One patient had recurrent triggering, which was successfully treated by a second procedure to resect the remaining FDS slip. Another patient was successfully treated with excision of an aberrant muscle belly from the FDS. Both of these patients remained asymptomatic after their revision procedures. No other complications were observed. All patients returned to full activities, and 17 of 18 (94%) patients were satisfied with the results of surgery at most recent follow-up evaluation.

CONCLUSIONS

The pediatric trigger finger may be safely and predictably treated by surgical release of the A1 pulley and resection of a single FDS tendon slip.