Huang Peng, Wang Dahui, Wu Chunxing, Song Jun, Ning Bo
Department of Orthopaedics Surgery, Children's Hospital of Fudan University, National Children's Medical Center, Minhang, Shanghai, China.
J Pediatr Orthop. 2023 Mar 1;43(3):177-180. doi: 10.1097/BPO.0000000000002339. Epub 2022 Dec 28.
The metachronism of bilateral trigger thumb (TT) may lead to additional surgery under anesthesia. The aim of this study was to investigate the temporal development of bilateral TT, find risk factors for contralateral TT, and provide evidence for clinical practice.
A retrospective analysis was performed on children diagnosed with TT in our hospital from January 2016 to December 2019. Age at onset, laterality, sex, the interval time of onset of contralateral symptoms, age at the time of surgery, and preoperative and postoperative follow-up times were collected. The cases were divided into 3 groups: (1) the unilateral group, (2) the simultaneous bilateral group, and (3) the separate bilateral group.
A total of 783 patients with 967 TTs were enrolled. There were 599 (76.5%) cases in the unilateral group, 157 (20.1%) cases in the simultaneous bilateral group, and 27 (3.4%) cases in the separate bilateral group. Seven (0.9%) patients underwent additional surgery on the contralateral side under anesthesia. Of these 7 patients, 6 (85.7%) had left-side onset and 5 (71.4%) patients developed bilateral TT by the age of 4. The mean age at the initial onset in the separate bilateral group was 20.1 months, and the mean age at diagnosis of the contralateral thumb was 33.6 months. Binary logistic regression analysis showed that age and side at initial onset had significant differences ( P =0.043 and 0.000, respectively). Receiver operating characteristic curve analysis showed that the cutoff value of age at initial onset was 16 months.
There was a low incidence of metachronous bilateral TT with additional surgery for the contralateral thumb. Age and side at initial onset are risk factors for contralateral TT.
Level II; prognostic studies.
双侧扳机指（TT）的异时性可能导致在麻醉下进行额外手术。本研究的目的是调查双侧TT的时间发展情况，找出对侧TT的危险因素，并为临床实践提供依据。
对2016年1月至2019年12月在我院诊断为TT的儿童进行回顾性分析。收集发病年龄、左右侧、性别、对侧症状发病间隔时间、手术时年龄以及术前和术后随访时间。病例分为3组：（1）单侧组，（2）同时双侧组，（3）异时双侧组。
共纳入783例患者，967个扳机指。单侧组599例（76.5%），同时双侧组157例（20.1%），异时双侧组27例（3.4%）。7例（0.9%）患者在麻醉下对侧进行了额外手术。在这7例患者中，6例（85.7%）首发于左侧，5例（71.4%）患者在4岁时出现双侧TT。异时双侧组首次发病的平均年龄为20.1个月，对侧拇指诊断时的平均年龄为33.6个月。二元逻辑回归分析显示，首次发病的年龄和侧别存在显著差异（分别为P = 0.043和0.000）。受试者工作特征曲线分析显示，首次发病年龄的截断值为16个月。
异时性双侧TT且对侧拇指进行额外手术的发生率较低。首次发病的年龄和侧别是对侧TT的危险因素。
二级；预后研究。
