Rao Vinay, Ericson William B
The Warren Alpert Medical School of Brown University, Providence, RI, USA.
Ericson Hand and Nerve Center, Mountlake Terrace, WA, USA.
Hand (N Y). 2022 May;17(3):NP5-NP8. doi: 10.1177/15589447211052754. Epub 2021 Oct 26.
Pediatric trigger thumbs present a conundrum for hand surgeons. Surgery for trigger thumbs has inherent risks, such as infection, nerve injury, and the risks of anesthesia, but will reliably solve the problem. But is surgical intervention necessary? Would these cases resolve spontaneously, eventually, without intervention? If not, what are the long-term consequences of the inability to fully extend the thumb interphalangeal joint? We present a pediatric trigger thumb that was symptomatic for 22 years, with complete resolution of symptoms after surgical intervention. This report illustrates at least some pediatric trigger thumbs will not resolve without surgical intervention, but treatment, even after 21 years, can result in normal thumb motion and function.
小儿扳机指给手外科医生带来了一个难题。扳机指手术存在诸如感染、神经损伤以及麻醉风险等固有风险，但能可靠地解决问题。但手术干预是否必要呢？这些病例最终会在不进行干预的情况下自行缓解吗？如果不会，拇指指间关节无法完全伸直的长期后果是什么？我们报告一例有症状22年的小儿扳机指，手术干预后症状完全缓解。本报告表明，至少有些小儿扳机指不进行手术干预不会缓解，但即便在21年后进行治疗，仍可使拇指运动和功能恢复正常。
