Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Division of Plastic Surgery, Dalhousie University, Halifax, NS, Canada.
J Hand Surg Eur Vol. 2022 Feb;47(2):192-196. doi: 10.1177/17531934211035642. Epub 2021 Oct 5.
Paediatric trigger finger is a rare condition distinct from paediatric trigger thumb and adult trigger digits. We performed a systematic review of paediatric trigger finger presentation and aetiology in order to guide workup and management. Fifty-one studies with 193 patients and 398 trigger fingers were included. Most patients had a single, unilateral trigger finger (54%). Fifty-five patients (29%) had an underlying condition, such as mucopolysaccharidosis; these cases appeared to be associated with multiple or bilateral trigger fingers or with carpal tunnel syndrome. All patients with mucopolysaccharidosis were treated surgically. Conservative management was reported in 33% of all patients, and two-thirds of these did not need further intervention. Patients undergoing surgical release infrequently had recurrence of triggering (6%). We propose an algorithmic approach for patients presenting with paediatric trigger finger. Presence of bilateral or multiple trigger digits or concomitant carpal tunnel syndrome should raise suspicion for an atypical underlying pathology.
小儿扳机指是一种罕见的疾病，与小儿扳机拇指和成人扳机指不同。我们对小儿扳机指的表现和病因进行了系统回顾，以指导检查和治疗。共纳入 51 项研究，涉及 193 名患者和 398 个扳机指。大多数患者为单发、单侧扳机指（54%）。55 名患者（29%）存在潜在疾病，如黏多糖贮积症；这些病例似乎与多发性或双侧扳机指或腕管综合征有关。所有黏多糖贮积症患者均接受手术治疗。所有患者中有 33%接受了保守治疗，其中三分之二的患者无需进一步干预。接受手术松解的患者扳机指复发的情况很少（6%）。我们提出了一种针对小儿扳机指患者的算法方法。双侧或多发性扳机指或同时存在腕管综合征应提示存在非典型的潜在病理。
